Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942012000200005
Brazilian Journal of Anesthesiology
Scientific Article

Complicações pós-operatórias menores relacionadas à anestesia em pacientes de cirurgias eletivas ginecológicas e ortopédicas em um hospital universitário de Kingston, Jamaica

Minor postoperative complications related to anesthesia in elective gynecological and orthopedic surgical patients at a teaching hospital in Kingston, Jamaica

Ingrid Tennant; Richard Augier; Annette Crawford-Sykes; Doreen Ferron-Boothe; Nicola Meeks-Aitken; Karen Jones; Georgiana Gordon-Strachan; Hyacinth Harding-Goldson

http://dx.doi.org/10.1590/S0034-70942012000200005 Braz J Anesthesiol, vol.62, n2, p.193-198, 2012
PDF Português
PDF English
Downloads: 1
Views: 907

Resumo

JUSTIFICATIVA E OBJETIVOS: As complicações anestésicas pós-operatórias menores podem aumentar o desconforto e a insatisfação do paciente e retardar sua recuperação. Este trabalho procurou determinar a frequência das complicações menores relatadas nas primeiras 48 horas do período pós-operatório por pacientes de cirurgias eletivas (ginecológicas e ortopédicas) no University Hospital of the West Indies, Jamaica. A satisfação geral com os cuidados anestésicos e os possíveis fatores de risco para desenvolver complicações também foram avaliados. MÉTODOS: Um estudo prospectivo e descritivo de coorte foi realizado por meio de entrevistas com pacientes operados 24 e 48 horas após a anestesia. Os dados foram analisados usando SPSS versão 12 e avaliados pelo teste do χ2-quadrado e modelos de regressão logística múltipla. RESULTADOS: Foram incluídos 505 pacientes, sendo 374 do sexo feminino (74%). A maioria era ASA I (55%) ou ASA II (38%) e foi submetida à anestesia geral (80%). Um total de 419 (83%) pacientes relataram pelo menos uma complicação pós-operatória. As complicações mais relatadas foram dor de garganta (44%), náusea (30%), vômito (24%) e tromboflebite (20%). A moda do Índice de Classificação Numérica Verbal (ICNV) para cada complicação variou entre 2 e 5, sugerindo que a maioria não causa desconforto grave. Idade inferior a 45 anos (OR 2,22, IC de 95% 1,34-3,69, p = 0,002) e sexo feminino (OR 3,64, IC de 95% 2,14-6,20, p < 0,001) foram identificados como variáveis independentes significativas. A maioria dos pacientes considerou sua experiência anestésica como excelente (51%) ou muito boa (22%). CONCLUSÃO: Este estudo mostrou uma incidência relativamente alta de complicações menores pós-operatórias (83%), mas baixa gravidade dos sintomas relatados e um alto grau de satisfação geral. Deve ser dada atenção especial à redução dessas complicações menores por meio de técnicas anestésicas mais meticulosas.

Palavras-chave

AVALIAÇÃO, COMPLICAÇÕES, RECUPERAÇÃO PÓS-ANESTÉSICA

Abstract

BACKGROUND AND OBJECTIVES: Minor postoperative anesthetic complications may increase patient discomfort and dissatisfaction and delay recovery. This paper sought to determine the frequency of minor complications in the first 48 hours postoperatively reported by elective gynecological and orthopedic surgical patients at the University Hospital of the West Indies, Jamaica. Overall satisfaction with anesthetic care and possible risk factors for developing complications were also assessed. METHODS: A prospective, descriptive cohort study was undertaken with patient interviews 24 to 48 hours after anesthesia. Data were analyzed using SPSS version 12 and assessed using the χ2-square test and multiple logistic regression models. RESULTS: Five hundred and five (505) patients were included, with 374 females (74%). Most were ASA I (55%) or ASA II (38%) and had general anesthesia (80%). A total of 419 (83%) patients reported at least one complication postoperatively. The most frequently reported complications were sore throat (44%), nausea (30%), vomiting (24%), and thrombophlebitis (20%). The mode of the Verbal Numerical Rating Score (VNRS) for each complication ranged between 2 and 5, suggesting that most did not cause severe distress. Age less than 45 years (OR 2.22, 95% CI 1.34-3.69, p = 0.002) and female gender (OR 3.64, 95% CI 2.14-6.20, p < 0.001) were identified as significant independent variables. Most patients regarded their anesthetic experience as excellent (51%) or very good (22%). CONCLUSION: This study showed a comparatively high incidence of minor postoperative complications (83%), but low reported severity of symptoms and a high overall satisfaction rate. Special attention should be paid to reduce these minor complications through more meticulous anesthetic technique.

Keywords

Anesthesia Department, Patient Satisfaction, Postoperative Complications, Postoperative Period

Referencias

Kehlet H, Dahl JB. Anaesthesia, surgery, and challenges in postoperative recovery. Lancet. 2003;362:1921-1928.

Jenkins K, Baker AB. Consent and Anesthetic risk. Anaesthesia. 2003;58:962-984.

Domino KB, Posner KL, Caplan RA, Cheney FW. Awareness during anesthesia: a closed claims analysis. Anesthesiology. 1999;90:1053-1061.

Myles PS, Williams DL, Hendrata M, Anderson H, Weeks AM. Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients. Br J Anaesth. 2000;84:6-10.

Cohen MM, Duncan PG, Pope WD, Wolkenstein C. A survey of 112,000 Anesthetics at one teaching hospital (1975-83). Can Anaesth Soc J. 1986;33:22-31.

Tennant IA, Augier R, Crawford-Sykes A, Hambleton IR, Tha M, Harding H. Anesthetic morbidity at the University Hospital of the West Indies. West Indian Med J. 2009;58:452-459.

Cohen MM, Duncan PG, Tweed WA. The Canadian four-centre study of Anesthetic outcomes: I. Description of methods and populations. Can J Anaesth. 1992;39:420-429.

Myles PS, Hunt JO, Moloney JT. Postoperative minor complications: Comparison between men and women. Anaesthesia. 1997;52:300-306.

East JM, Mitchell DIG. Postoperative nausea and vomiting in laparoscopic versus open cholecystectomy at two major hospitals in Jamaica. West Ind Med J. 2009;58:130-137.

Lee A, Lum ME. Measuring Anesthetic outcomes. Anaesth Intensive Care. 1996;24:685-693.

Layzell M. Exploring pain management in older people with hip fracture. Nursing Times. 2009;105:20-23.

Parker A. Care of the older perioperative patient. Br J of Anesthetic and Recovery Nursing. 2002;8:21-27.

Capuzzo M, Gilli G, Paparella L. Factors predictive of patient satisfaction with anesthesia. Anesth Analg. 2007;105:435-442.

Hennekens CH, Buring JE. Epidemiology in medicine. 1987:274.

5dd54a8b0e8825c96dc8fca6 rba Articles
Links & Downloads
2352-2291 (Electrónico) 0104-0014 (Impreso)
Braz J Anesthesiol ©2024 Todos los derechos reservados.

Braz J Anesthesiol

Share this page
Page Sections