State of Play of Anesthesia for Outpatient Medical and Surgical Procedures in the City of Kinshasa

Abstract

Context and Objective: The practice of outpatient anaesthesia has many advantages over anesthesia with conventional hospitalisation, particularly in the reduction of post-operative complications and the faster resumption of activity, etc. No study has been carried out on this subject in our community; this study was carried out in order to come up with a concrete state of play when it comes to outpatient anesthesia for medical and surgical procedures in the city of Kinshasa. Methodology: This was a cross-sectional study, which took place in seven hospitals in the city of Kinshasa from 1 November 2020 to 31 January 2021. The population consisted of all patients who received outpatient anesthesia and the included patients had signed an informed consent. The variables of the study were the general profile of patients, surgical procedures and indications, anesthetic data and patient evolution. Statistical analyses were performed with SPPS 21.0 with p Results: We collected data from 971 patients who had undergone anesthesia in the seven medical facilities in the city of Kinshasa. Among these patients, 394 had benefited from outpatient anesthesia, i.e. a frequency of outpatient anesthesia estimated at 40.5%. Three hundred and ninety-four (394) patients were selected. They were 58.6% women and 41.4% men i.e. a sex ratio M/F of 0.7. The mean age was 39.3 ± 18.7 years with the extremes of 1 and 82 years. Gastroscopy was the most performed (operative) procedure (21.6%). Patients were classified as ASA 1 in 75.1%, narcosis (80.7%) using propofol (80.2%) was the most used anesthetic technique and performed by a specialist doctor in Anesthesia in 65.5%. Suxamethonium was the most used curare in 13.2%. Fentanyl was the most used opioid in 14.5%. Bupivacaine (10.9%) was the most widely used local anesthetic. Eleven patients or 3.2% had complications and, i.e. (0.8%) were hospitalized, class ASA II appeared to be a factor associated with complications. Conclusion: Ambulatory anesthesia is a reality in the city of Kinshasa; however, it is still underdeveloped and mainly concerns explorations (gastroscopy, colonoscopy, laparoscopy…) and some minor procedures. This anesthesia mainly uses propofol and is done by the specialist doctor. A high-powered study and an evaluation of this practice in the light of international recommendations would be useful.