Anaesthetic management of acute abdomen: a clinical study

ABSTRACT

Background: Patients of acute abdomen present anaesthetic problems like fluid and electrolyte loss, intraoperative vomiting, regurgitation and aspiration, postoperative sickness, electrolyte imbalance, prolonged total parenteral alimentation etc. This study focused on intraoperative and postoperative complications with reference to anaesthetic management.Methods: Around 300 patients, suffering from acute abdomen, operated during routine or emergency were randomly distributed in three groups, Group I General anaesthesia with narcotic analgesics and relaxants; Group II General anaesthesia with inhalational agents; Group III Spinal subarachnoid analgesia. No modification of pre and post-operative hospital care and treatment was done.Results: There was a preponderance of younger age group patients (15 to 34years), more often in male patients. The mean duration in Group I was highest. Intraoperative Hypotension was the commonest (86 patients) followed by regurgitation and aspiration. Post-operative pyrexia was the commonest complication (120 patients) followed by postoperative nausea. ASA Grade III had a mortality of 22 patients (11.6%), ASA Grade IV having mortality of 46 patients (60.52%). About 221 patients had long duration of operations and the mortality was 28.95% as compared to 79 patients operated for short duration having mortality of 13.92%.Conclusions: Outcome and the survival of the patients depend on the surgical disease, duration of surgery, preoperative ASA grading, degree of dehydration, and the anaesthetic technique.