Anaesthetic Practice in Urological Surgery in a Tertiary Hospital at Brazzaville - Congo

K Mahoungou Guimbi, PD Mawandza, AWS Odzebe, U Biez, M Atipo, AP Bouya

Abstract


urpose. To evaluate anaesthetic practice during urological surgery procedures.
Patients and methods. This was a retrospective study of anaesthetic records of patients undergoing elective urological surgery. We studied comorbidities, anaesthetic technique, incidents and accidents, duration of surgery, surgical procedure and use of blood transfusion. Results. 194 patients were included. Their mean age was 52.7 years (range 16-94 years). Females constituted 14.5% of the study population. Hypertension was found in 40 (20.6%) patients and was the main comorbidity. ASA class 1 included 118 (60.8%) patients. Locoregional anaesthesia performed in 167 cases (86.1%) was the predominant anaesthetic technique. Sedation concerned 21 (10.8%) patients and 35 (18.1%) patients received general anaesthesia. intraoperative incidents were found in to 44.8%, including hypotension (80%) and bradycardia (15%). The mean duration of surgery was 85.3 ± 50.6 minutes, and adenomectomy was the most common surgical procedure. Blood transfusion concerned 29 (14.9%) patients. Medical supervision of anaesthetic actions was present in 33.7% of cases. Conclusion. Anaesthesia in urological surgery concerns mainly adult patients. Medical supervision is low and the rate of intraoperative incidents high. Working time organisation for the medical team would probably improve these practices.

RÉSUMÉ
But. évaluer la pratique anesthésique au cours des interventions de chirurgie urologique. Patients et méthodes. Il s’agit d’une étude rétrospective portant sur des dossiers anesthésiques des patients opérés pour une intervention élective de chirurgie urologique. Résultats. 194 dossiers ont été retenus. L’âge moyen des patients était de 52,7 ans (extrêmes : 16-94 ans). Le sexe féminin constituait 14,5% de la population d’étude. L’HTA présente chez 40 (20,6%) patients représentait la principale comorbidité. La classe ASA 1 comportait 118 (60,8%) patients. L’anesthésie locorégionale pratiquée dans 167 cas (86,1%) était la technique la plus courante. La sédation concernait 21 (10,8%) patients, et l’anesthésie générale 35 (18,1%) patients. La fréquence des incidents préopératoires s’élevait à 44,8%. La durée moyenne de la chirurgie était de 85,3±50,6 minutes, et l’adénomectomie prostatique la première intervention chirurgicale. La transfusion sanguine concernait 29 (14,9%) patients. La supervision médicale des actes anesthésiques avoisinait un taux de 33,7%. Conclusion. l’anesthésie en chirurgie urologique s’adresse au patient adulte. La supervision médicale y est faible et le taux d’incidents préopératoires élevé. Une organisation du temps de travail pour l’équipe médicale permettrait sans doute d’améliorer ces pratiques.


Keywords


Anaesthesia; prostate surgery; spinal anaesthesia; urology

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