Binam F, Lemardeley P, Blatt A, Arvis T
Département d'anesthésie-réanimation, Hôpital Central, Faculté de Médecine et des Sciences Biomédicales (FMSB) Yaoundé, Cameroun.
Ann Fr Anesth Reanim. 1999 Jun;18(6):647-56. doi: 10.1016/s0750-7658(99)80152-x.
This descriptive and prospective study, carried out during a 6-month period at Yaounde (Cameroon), assessed work practices relating to anaesthesia in public and private health care institutions, the incidence and causes of complications, and considers possible means for improving security of the anaesthetized patient. This study included 1,103 patients, aged 12 days to 89 years. Main surgical indications were gynaecology-obstetrics (33.3% of cases) and emergency surgery (28.6% of cases). Anaesthetic practices were characterized by an unsuitable and non systematic use of procedures which are essential parts of a safe anaesthetic. Pre-anaesthetic assessment was carried out in 71.4% of cases, premedication in 78.4% of cases and management in recovery room in 24% of cases only. Patients were anaesthetized by nurses in 78.6% of cases (40% of them had been trained on-the-job only). The anaesthesia equipment of operating room was poor in most places, especially with respect to physiological monitors. The rate of complications, 476 in 321 patients (29.1% of cases), was similar to the incidence registered in 1977 (30%). Twenty-four deaths occurred (overall mortality rate of 2.2%). Besides the shortage of equipment, this study underlines the necessity for producing and adhering to guidelines for safe practice of anaesthesia, adapted for developing countries.
这项描述性前瞻性研究在喀麦隆雅温得进行，为期6个月，评估了公共和私立医疗机构中与麻醉相关的工作实践、并发症的发生率和原因，并探讨了提高麻醉患者安全性的可能方法。该研究纳入了1103名年龄在12天至89岁之间的患者。主要手术指征为妇产科（33.3%的病例）和急诊手术（28.6%的病例）。麻醉实践的特点是对安全麻醉至关重要的程序使用不当且不系统。71.4%的病例进行了麻醉前评估，78.4%的病例进行了术前用药，而只有24%的病例在恢复室进行了管理。78.6%的病例由护士实施麻醉（其中40%仅接受过在职培训）。大多数地方手术室的麻醉设备很差，尤其是生理监测仪方面。321名患者中出现476例并发症（发生率为29.1%），与1977年记录的发生率（30%）相似。发生了24例死亡（总死亡率为2.2%）。除了设备短缺外，这项研究强调了制定并遵守适合发展中国家的安全麻醉实践指南的必要性。
