Operating Room Deaths

A ten-year retrospective survey of the rate and pattern of death of patients within the operating theatre suites was carried out at the University of Benin Teaching Hospital; Benin City; Nigeria. Of the 12;743 patients who were admitted to the operating theatre suites in the period; excluding obstetric cases; 47 (i.e. 0.37) deaths were recorded; consisting of 24 males and 23 females; aged between 5 months and 72 years. Thirty-two (68) of the deaths were associated with emergency procedures; and fifteen (32) were elective. Thirty-six of the patients (76.6); had general anaesthesia. The patients' medical condition contributed to 51of the deaths; followed by anesthesia (38.3) and surgery (8.5). Twenty-four of the deceased (51.1); were booked for abdominal surgery; while head/neck procedures accounted for 14 (29.8). The death rate of 37 per 10;000 seems high; when compared to western values; but is akin to figures from similar institutions in developing countries like ours

Spinal (Intrathecal) Ketamine Anaesthesia for Upper Abdominal Surgery : Case Report

Intravenous ketamine is usually administered for the induction of general anaesthesia. Spinal ketamine for lower abdominal and lower limb surgery is sporadically reported in the literature. However; the use of spinal ketamine for upper body surgery is rare. We describe the case of a 35-year old man; with a retroperitoneal tumour and severe intercurrent cardiovascular morbidity; that had exploratory laparotomy and tumour biopsy with Intrathecal ketamine administered through the L4/L5 interspace. The patient had good surgical analgesia; with stable vital signs throughout the surgery. After surgery; the spinal catheter was left in place; and withdrawn 48 hours later. The patient did well in the immediate postoperative period; although he gradually succumbed to the primary illness (malignant retroperitoneal cancer) on the 15th postoperative day