Objective: The role of anesthesia in maternal mortality is unknown in the Democratic Republic of Congo (DRC). This study was conducted with the objective of analyzing the determinants of morbidity and maternal mortali...Objective: The role of anesthesia in maternal mortality is unknown in the Democratic Republic of Congo (DRC). This study was conducted with the objective of analyzing the determinants of morbidity and maternal mortality linked to anesthesia in course of cesarean section. Methods: This is a prospective, analytical and mono-centric study carried out on women who underwent cesarean section at the Centre Hospitalier Mère-Enfant Monkole from January 1st, 2011 to December 31st, 2018. The variables analyzed were socio-demographic, clinical, biological and anesthetic as well as the maternal issues. Data analysis was performed with SPSS 21.0 software. The determinants of mortality were sought by logistic regression with p Results: During this period, 1954 cesarean sections were performed. The mean age of the women was 31 years (range 14 to 47), 1549 women (79.3%) had completed prenatal consultation in Monkole and 405 (20.7%) elsewhere. The emergency was extreme in 192 cases (9.82%), absolute in 445 (22.77%) and relative in 1317 (67.4%). Locoregional anesthesia (LRA) was performed in 1811 cases (92.68%). The main complications were marked by arterial hypotension (22.9%) due to spinal anesthesia, and mortality was 0.56%. In multivariate analysis, only extreme emergency (aOR 7.62 95% CI: 2.80 - 71.23 p = 0.007), coma on admission (aOR 10.44 95% CI: 1.81 - 60.13 p = 0.009), general anesthesia (aOR 15.41 95% CI: 2.11 - 40.21 p = 0.007) and intraoperative transfusion due to anemia/hemorrhage (aOR 8.63 95% CI: 1.07 - 69.55 p = 0.043) persisted as determinants of maternal death. Conclusion: Maternal mortality (0.56%) in this series was relatively low for a low-income country and no death was directly related to anesthesia. General anesthesia, extreme urgency, intraoperative transfusion due to anemia/bleeding, and coma on admission were the major determinants of mortality.展开更多
Objective: Anesthesia for laparoscopic surgery is particular because of the cardiopulmonary repercussions of pneumoperitoneum. This study reports the experience in secondary level hospital located in suburban environm...Objective: Anesthesia for laparoscopic surgery is particular because of the cardiopulmonary repercussions of pneumoperitoneum. This study reports the experience in secondary level hospital located in suburban environment. Methods: This is a cross-sectional study carried out at Monkole hospital from May 2016 to May 2023. It concerns patients anesthetized for laparoscopic surgery. Perianesthetic data were collected and analyzed with SPSS 26.0 for p Results: Eighty-four patients (4.2%) were selected out of 2000 eligible patients. The median age was 31 years, the range between 15 and 30 years (40.5%), female gender and approved patients (70.3%) predominated. Comorbidities were: sickle cell disease, high blood pressure, thinness and obesity. The ASA class was: I (35.2%), II (36.3%) and III (28.6%). Anesthesia was general with intubation for all patients. Generally, the surgery lasted less than two hours and the anesthesia lasted more than two hours. Postoperative analgesia used morphine in 27.5%. The operative indications were dominated by lithiasis with or without cholecystitis (48.4%) and appendicitis (16.5%). Intraoperative complications (18.7%) were: hypotension, allergy, spasm, accidental gallbladder and bile duct perforation. Postoperative complications (9.9%) were: anemia, digestive fistula, septic shock, multi-organ failure, acute lung edema and two deaths. Alcohol consumption was associated with intraoperative complications. Anesthesia duration greater than two hours, ASA3 class, alcohol consumption and cholecystectomy were associated with postoperative complications. Conclusion: Celiosurgery is not yet established in Monkole probably due to the lack of permanent surgeons and the higher cost than open surgery.展开更多
文摘Objective: The role of anesthesia in maternal mortality is unknown in the Democratic Republic of Congo (DRC). This study was conducted with the objective of analyzing the determinants of morbidity and maternal mortality linked to anesthesia in course of cesarean section. Methods: This is a prospective, analytical and mono-centric study carried out on women who underwent cesarean section at the Centre Hospitalier Mère-Enfant Monkole from January 1st, 2011 to December 31st, 2018. The variables analyzed were socio-demographic, clinical, biological and anesthetic as well as the maternal issues. Data analysis was performed with SPSS 21.0 software. The determinants of mortality were sought by logistic regression with p Results: During this period, 1954 cesarean sections were performed. The mean age of the women was 31 years (range 14 to 47), 1549 women (79.3%) had completed prenatal consultation in Monkole and 405 (20.7%) elsewhere. The emergency was extreme in 192 cases (9.82%), absolute in 445 (22.77%) and relative in 1317 (67.4%). Locoregional anesthesia (LRA) was performed in 1811 cases (92.68%). The main complications were marked by arterial hypotension (22.9%) due to spinal anesthesia, and mortality was 0.56%. In multivariate analysis, only extreme emergency (aOR 7.62 95% CI: 2.80 - 71.23 p = 0.007), coma on admission (aOR 10.44 95% CI: 1.81 - 60.13 p = 0.009), general anesthesia (aOR 15.41 95% CI: 2.11 - 40.21 p = 0.007) and intraoperative transfusion due to anemia/hemorrhage (aOR 8.63 95% CI: 1.07 - 69.55 p = 0.043) persisted as determinants of maternal death. Conclusion: Maternal mortality (0.56%) in this series was relatively low for a low-income country and no death was directly related to anesthesia. General anesthesia, extreme urgency, intraoperative transfusion due to anemia/bleeding, and coma on admission were the major determinants of mortality.
文摘Objective: Anesthesia for laparoscopic surgery is particular because of the cardiopulmonary repercussions of pneumoperitoneum. This study reports the experience in secondary level hospital located in suburban environment. Methods: This is a cross-sectional study carried out at Monkole hospital from May 2016 to May 2023. It concerns patients anesthetized for laparoscopic surgery. Perianesthetic data were collected and analyzed with SPSS 26.0 for p Results: Eighty-four patients (4.2%) were selected out of 2000 eligible patients. The median age was 31 years, the range between 15 and 30 years (40.5%), female gender and approved patients (70.3%) predominated. Comorbidities were: sickle cell disease, high blood pressure, thinness and obesity. The ASA class was: I (35.2%), II (36.3%) and III (28.6%). Anesthesia was general with intubation for all patients. Generally, the surgery lasted less than two hours and the anesthesia lasted more than two hours. Postoperative analgesia used morphine in 27.5%. The operative indications were dominated by lithiasis with or without cholecystitis (48.4%) and appendicitis (16.5%). Intraoperative complications (18.7%) were: hypotension, allergy, spasm, accidental gallbladder and bile duct perforation. Postoperative complications (9.9%) were: anemia, digestive fistula, septic shock, multi-organ failure, acute lung edema and two deaths. Alcohol consumption was associated with intraoperative complications. Anesthesia duration greater than two hours, ASA3 class, alcohol consumption and cholecystectomy were associated with postoperative complications. Conclusion: Celiosurgery is not yet established in Monkole probably due to the lack of permanent surgeons and the higher cost than open surgery.
