Ouro-Bang'na Maman A F, Agbétra N, Egbohou P, Sama H, Chobli M
Service d'anesthésie-réanimation, CHU de Lomé (Togo), 05 BP 383 Agbalépédogan, Lomé, Togo.
Ann Fr Anesth Reanim. 2008 Dec;27(12):1030-3. doi: 10.1016/j.annfar.2008.08.015. Epub 2008 Nov 17.
New evaluation of early perioperative morbidity and mortality four years after the first study in 2002, at Lomé teaching hospital (Togo).
It was a prospective and descriptive survey during the first semester of 2006. After approval of hospital ethic committee, medical and demographic data, complications and early perioperative deaths have been analyzed.
One thousand nine hundred and two anaesthesia was delivered: 58% were women, the average age was 26 years, 94% of patient ASA<3, general anaesthesia (GA) 53% versus regional anaesthesia (LRA): 47%. Spinal anaesthesia (SA) represented 42% of anaesthetic procedures, and emergencies, 56%. 5.49% of complications including 16.16% of deaths were recorded. Death occurred in 69% after GA, and in 60% in the operating room. Seventy percent of patients had cardiovascular complications (five deaths), 30% respiratory failure (six deaths), 11% kidney failures (two deaths). Three deaths were linked to surgery (inadequate management of perioperative haemorrhage). Early perioperative mortality rate was 0.89%. Four cases occurred in the operating room and 12 in intensive care. Deaths were observed often in gynecology and obstetrics (9/16), especially in emergency situations (12/16) and in 75% of cases, patients were ASA>2. Deaths occurred in 13 cases after GA and in three cases after SA.
This mortality rate was smaller than in 2002. This may be explained by a better prenanaesthetic risk evaluation performed by anaesthetists, the creation of postoperative recovery room, the promotion of regional anaesthesia and the availability of succinylcholine in obstetrics. Significant improvement is still necessary and only be obtained by a national health policy.
对2002年在洛美教学医院（多哥）进行的首次研究四年后的围手术期早期发病率和死亡率进行重新评估。
这是一项2006年上半年的前瞻性描述性调查。经医院伦理委员会批准后，对医疗和人口统计学数据、并发症及围手术期早期死亡情况进行了分析。
共实施了1902例麻醉：58%为女性，平均年龄26岁，94%的患者美国麻醉医师协会（ASA）分级<3级，全身麻醉（GA）占53%，而区域麻醉（LRA）占47%。脊髓麻醉（SA）占麻醉操作的42%，急诊手术占56%。记录到5.49%的并发症，其中包括16.16%的死亡病例。GA后死亡病例占69%，手术室死亡病例占60%。70%的患者出现心血管并发症（5例死亡），30%出现呼吸衰竭（6例死亡），11%出现肾衰竭（2例死亡）。3例死亡与手术相关（围手术期出血管理不当）。围手术期早期死亡率为0.89%。4例死亡发生在手术室，12例发生在重症监护室。死亡病例常见于妇产科（9/16），尤其是急诊情况（12/16），75%的病例中患者ASA分级>2级。GA后有13例死亡，SA后有3例死亡。
该死亡率低于2002年。这可能是由于麻醉医生进行了更好的麻醉前风险评估、设立了术后恢复室、推广了区域麻醉以及产科可获得琥珀酰胆碱。仍有必要进行显著改善，且只有通过国家卫生政策才能实现。
