Abstract
ANAESTHETIC TECHNIQUES FOR ORTHOPAEDIC SURGERIES IN BENUE STATE UNIVERSITY TEACHING HOSPITAL (BSUTH), MAKURDI, NIGERIA

*Efu ME, Elachi IC and Ojo BA.

ABSTRACT

Background: Orthopaedic surgery entails operating on osseous and non-osseous structures of the limbs, spine and joints of the body. Like all other surgeries, orthopaedic surgeries require the administration of anaesthesia to patients. Central neuraxial blocks for lower limb surgeries has gained worldwide acceptance because it has lower mortality rates, shorter hospital stay, reduced patient cost and decreased in-hospital complications. General anaesthesia (GA) and regional anaesthesia (RA) have been used successfully for upper extremity orthopaedic procedures. It is also the technique of choice in the paediatric age group, the critically ill patients as well as being use for upper limb surgeries. This study was undertaken to ascertain the anaesthetic techniques employed in orthopaedic surgeries in the Benue State University Hospital, Makurdi. Methodology: A total of 117 case files of eligible patients were retrieved from the records department. Relevant information were extracted from the patients’ folders and transferred into a prepared proforma. Data collected were analyzed using SPSS version 25 using simple statistics. Results: A total of 117 orthopaedic surgical cases were evaluated. The age bracket with the most number is that between 21 t0 30 years with 28 making up 23.9% of the study population. Eighty-five patients were male, accounting for 72.6% of the study population, while 32 were female, making up the remaining 27.4%. Most of the patients were between ASA II and ASA III with 47 (40.2%) and 45 (27.4%). A total of 131preoperative diagnosis were made either singly or in combination with the two most common indications for surgery being femoral fracture and tibial fracture with 23 and 20 accounting for 17.3% and 15.0% of the variables. Of the total of 125 surgical procedures that were undertaken in this study, open reduction and internal fixation (ORIF) were carried the most, recording 35 accounting for 28.0% of the variables. Similarly, of the total of 117 anaesthetic procedures that were undertaken, sub-arachnoid block (SAB) was employed 65 times accounting for 55.6% of the variables.. Also, of the 13 episodes of complications that were recorded, hypotension was the most common having been recorded 7 times accounting for 53.8% of the variables. Again, of the 16 management modalities employed for the management of complication of the anaesthetic technique intravenous administration of ephedrine was carried out 5 times representing 31.3% of the variables. Conclusion: This study has demonstrated that regional anaesthesia is the most common anaesthetic technique used in this centre, mostly with the employment of SAB. GA is still being utilized mostly for children and upper limb surgeries. Training of personnel and the provision of modern equipment that aid regional technique will change the equation further in favour of these desirable techniques. That is where the world is going.

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