Anaesthetic outcomes in neonatal surgical care in a tertiary health facility in Nigeria

ABSTRACT

ABSTRACT There is always a concern about the survival of new-borns undergoing corrective surgical procedure early in life. Perioperative care, especially in sick babies, is challenging, and this makes ascribing outcomes to care given difficult. This study was aimed at determining and evaluating factors associated with poor outcomes in new-borns undergoing surgery and anaesthesia. This was a retrospective case notes review of 37 neonates who received general anaesthesia during surgical care over a three-year period. After ethical approval for the study, the demographic data, indications for surgery, American Society of Anesthesiologists' (ASA) classifications, preoperative, intraoperative and postoperative challenges present in these neonates as well as their outcome were extracted. A total of 48 neonates were operated over a three-year period, and only 37(77.1%) case files were available for review. Male Female ratio was about 21, the two most common procedures performed were bowel resection and anastomosis in 7(18.9%) and colostomy 7(18.9%). Overall mortality was 29.7%. Neonatal mortality was significantly higher in patients with postoperative sepsis (p=0.006) and respiratory challenge (p=0.035). The median time to death was 9 days. Only one (9.1%) patient died within 24hours postoperative. Mortality in neonates undergoing surgical procedure early in life is very high in this study. However, it is difficult to implicate anaesthesia in our study as the cause of mortality as most occurred very late after many days of surgery. Availability of postoperative elective ventilation for selected patients may improve outcome: