POST OPERATIVE COMPLICATION RELATED TO ANESTHESIA IN LOWER RESOURCES SETUP
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Abstract
Background: Post-operative respiratory complications are a significant concern following urogenital surgeries, particularly in patients administered general anesthesia. Hypoxemia, atelectasis, and hypoventilation are commonly reported, leading to extended hospital stays, ICU admissions, and elevated morbidity and mortality rates. These risks are further amplified by patient-related factors such as advanced age, obesity, and comorbidities. In resource-limited settings, constraints in respiratory monitoring and perioperative care intensify these outcomes, necessitating context-specific strategies to improve patient safety and post-operative recovery.
Objective: To determine the incidence, risk factors, and consequences of post-operative respiratory complications in patients undergoing urogenital surgeries, and to compare the respiratory outcomes between general and spinal anesthesia.
Methods: A retrospective observational study was conducted over six months at a tertiary care hospital. Data were collected for 50 patients aged 18 to 65 years who underwent urogenital surgery under general or spinal anesthesia. Patient demographics, comorbidities, anesthesia type, and post-operative respiratory outcomes were recorded. Descriptive and inferential statistics were applied using SPSS. Chi-square tests, t-tests, and multivariate regression analyses were performed to identify associations and risk factors. The impact of resource availability and preventive strategies—including early mobilization, incentive spirometry, non-invasive ventilation, and capnography—was also evaluated.
Results: Post-operative respiratory complications were observed in 60% of patients, with hypoxemia (28%), atelectasis (20%), and hypoventilation (16%) being the most prevalent. General anesthesia was associated with a higher complication rate (73.3%) compared to spinal anesthesia (26.7%). Risk factors significantly associated with complications included age > 60 years (p = 0.021), BMI ≥ 30 (p = 0.045), hypertension (p = 0.030), and diabetes mellitus (p = 0.018). Complications led to prolonged hospital stays (>7 days in 43.3% of cases), increased ICU admissions (33.3%), and a mortality rate of 10%. Limited access to capnography (64%), mechanical ventilators (50%), and respiratory therapists (70%) posed major challenges. Preventive strategies such as capnography monitoring (50% reduction), non-invasive ventilation (45%), and early mobilization (40%) were found to be significantly effective (p < 0.05).
Conclusion: Post-operative respiratory complications in urogenital surgeries remain a prevalent and serious concern, especially under general anesthesia and in high-risk patients. Resource constraints further exacerbate outcomes. However, low-cost preventive measures and targeted perioperative strategies can significantly reduce complication rates and improve patient safety.
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