Challenges of Neonatal Anaesthesia in a Tertiary Institution in Nigeria: A Ten-year Retrospective Review

Abstrak

Background: Successful management of neonatal p r o b l e ms  i s  f a c e d  wi t h  n ume r o u s  a n a e s t h e t i c challenges, especially in a low-resource country like Nigeria with significant morbidity and mortality. The study examined the challenges encountered during neonatal anaesthesia and its association with mortality in a tertiary institution.
Method: This is a 10-year retrospective study from January 2008 and December 2017 at the University Co l Ibadan, Nigeria. Neonates
anesthesized for neonatal surgery were recruited. Demographic data,  American Society of Anesthesiologist’s (ASA) status,  type of surgery, duration of surgery, intraoperative critical events and mortality were subjected to statistical analysis using SPSS version 23.
The association between intraoperative critical events and the type of surgery, ASA status, duration of surgery
and mortality was determined with chi square and the level of significance was set at p less than or equal to 0.05.
Results: A total of 356 neonatal data were retrieved with 215 (60.4%) males and 141 (39.6%) females. Overall, 35 (9.8%) neonates had intraoperative critical events (ICE) (hypotension 2.8%, hypothermia 14.4%,
difficult intubation 17.1%, desaturation 20%, cardiac
a r r e s t  1 7 . 1 % a n d  d e l a ye d  r e c o v e r y f r o m
anaesthesia28.6%).
Emergency surgery (p=0.004), ASA status (p=0.16)
and duration of surgery (p=0.03) were factors affecting
the ICE, 10 patients out of 35 patients with ICE died
hence ICE was associated with mortality (p=0.002).
Conclusion: Intraoperative critical events pose a
challenge during neonatal anaesthesia and risk factors
for critical events are emergency surgery and longer
duration of surgery are associated with mortality.
Efforts should be made to reduce these critical events
to obtain a better outcome.