Department of Anaesthesia and Intensive Care, College of Medicine, University of Malawi, Blantyre, Malawi.
Faculty of Medicine, Université Catholique du Graben, Butembo, Democratic Republic of the Congo.
BMC Anesthesiol. 2021 Feb 23;21(1):60. doi: 10.1186/s12871-021-01280-2.
General anaesthesia (GA) in developing countries is still a high-risk practice, especially in Africa, accompanied with high morbidity and mortality. No study has yet been conducted in Butembo in the Democratic Republic of the Congo to determine the mortality related to GA practice. The main objective of this study was to assess mortality related to GA in Butembo.
This was a retrospective descriptive and analytic study of patients who underwent surgery under GA in the 2 main teaching hospitals of Butembo from January 2011 to December 2015. Data were collected from patients files, anaesthesia registries and were analysed with SPSS 26.
From a total of 921 patients, 539 (58.5%) were male and 382 (41.5%) female patients. A total of 83 (9.0%) patients died representing an overall perioperative mortality rate of 90 per 1000. Out of the 83 deaths, 38 occurred within 24 h representing GA related mortality of 41 per 1000. There was a global drop in mortality from 2011 to 2015. The risk factors of death were: being a neonate or a senior adult, emergency operation, ASA physical status > 2 and a single deranged vital sign preoperatively, presenting any complication during GA, anaesthesia duration > 120 minutes as well as visceral surgeries/laparotomies. Ketamine was the most employed anaesthetic.
GA related mortality is very high in Butembo. Improved GA services and outcomes can be obtained by training more anaesthesia providers, proper patients monitoring, improved infrastructure, better equipment and drugs procurement and considering regional anaesthesia whenever possible.
在发展中国家，全身麻醉（GA）仍然是一种高风险的做法，尤其是在非洲，伴随着高发病率和死亡率。在刚果民主共和国的布滕博，尚未进行任何研究来确定与 GA 实践相关的死亡率。本研究的主要目的是评估布滕博 GA 相关死亡率。
这是一项回顾性描述性和分析性研究，对 2011 年 1 月至 2015 年 12 月在布滕博 2 家主要教学医院接受 GA 手术的患者进行了研究。数据来自患者档案、麻醉登记册，并使用 SPSS 26 进行分析。
在总共 921 名患者中，539 名（58.5%）为男性，382 名（41.5%）为女性患者。共有 83 名患者死亡，总死亡率为 90/1000。在 83 例死亡中，38 例发生在 24 小时内，GA 相关死亡率为 41/1000。死亡率从 2011 年到 2015 年呈全球下降趋势。死亡的危险因素是：新生儿或老年人、急诊手术、ASA 身体状况>2 以及术前单一生命体征异常、GA 期间出现任何并发症、麻醉持续时间>120 分钟以及内脏手术/剖腹术。氯胺酮是最常用的麻醉剂。
布滕博的 GA 相关死亡率非常高。通过培训更多的麻醉师、适当的患者监测、改善基础设施、更好的设备和药物采购以及尽可能考虑区域麻醉，可以获得更好的 GA 服务和结果。
