ANAESTHETIC PRACTICES IN AREAS WITH LIMITED RESOURCES AND PERSONNEL IN THE EASTERN PART OF THE DEMOCRATIC REPUBLIC OF THE CONGO (DRC)

Joel Kambale Ketha*, Piet Bekaert, Paulin Ruhato Banguti, Esperance Kavira Kavota, Samuel Kamate Masali, Michel Kalongo Ilumbulumbu, Moise Muhindo Valimungighe, Tecla Katungu Kitamwivirirwa, Sylvie Visavingi and Franck Katembo Sikakulya

ABSTRACT

Background: Satisfactory anaesthesia makes the surgeon’s intervention easier and more precise. Improvements in anaesthesia and intensive care during the last 30 years have enabled surgical procedures to be performed at the most extreme ages in life. This study describes the current anaesthetic practices at Beni General Referral Hospital in the DRC. Methodology: This was a retrospective study carried out from the 1st January to 31st December 2017 at Beni General Referral Hospital in the DRC. Result: Overall 1453 patients presented for surgery; women were represented in 63.4% of cases. The average age of patients was 24 +/- 0.9 years. The risk assessment showed that 97.2% of patients were ASA class I and II, surgical risk was shown to be intermediate in 66.3%, followed by minor surgical risk. Gynaecological and obstetric interventions were 43%, followed by traumatological and orthopaedic in 38.9% and abdominal in 10.6%. General anaesthesia with ketamine was most the commonly used technique, followed by spinal anaesthesia and local anaesthesia respectively in 43%, 37.8% and 19.2%. Atropine and diazepam have increasingly been used in combination for premedication. Anaesthesia was administered by nurse anaesthetists with less than 10 years of experience. Adverse events in most cases were cardiovascular. No deaths were recorded during surgery or the recovery period in the hour after the surgery. Conclusion: Due to deficiencies in equipment, technical support and training acceptable standards of anaesthetic practice do not currently exist at the Beni General Referral Hospital. This remains a public health problem in this environment which requires urgent attention.

Keywords: Practices, anaesthesia, Beni, DRC.