WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Efu M. E., Hembah-Hilekaan S. K., Ojo B. A.

ABSTRACT

Background: Caesarean section (CS) is an operative delivery of the fetus by means of surgical incision through the anterior abdominal wall and the uterus. CS is one of the most commonly performed surgeries worldwide. The anesthetic technique to be used in caesarean section is determined by certain factors like urgency, presence of coexisting diseases, preference of patient and preference and experience of the anesthetist and surgeon. With all these factors in mind, the most appropriate general or regional anesthetic technique is selected. In obstetric anesthesia, regional anesthesia (RA) is usually preferred unless there is a contraindication. This study was aimed at ascertaining the anesthetic technique employed for CS in the Benue State University Hospital (BSUTH), Makurdi, Nigeria. Methodology: This was a retrospective study of 100 consecutive caesarean sections carried out with effect from January 2017 in BSUTH, Makurdi, a 360 bed hospital situated in the capital city of Benue Sate, North Central of Nigeria. The approval of the BSUTH Research and Ethical Committee was sought and obtained. A total of 100 case files of eligible patients were retrieved from the records department of BSUTH. Relevant information were extracted from the patients’ folders and transferred into a prepared proforma. Data collected include age, sex, ASA classification, pre-operative diagnosis, surgical procedure undertaken, whether surgery was elective or emergency, anesthetic technique employed, complications of the technique and the management of such complications. The data collected were analyzed using SPSS version 25 and presented using simple statistics. Results: The age bracket between 21 years and 30 years constituted 69% of the study population. Also the bracket between 31 years and 40 years made up 23% of the population evaluated. The combination of these two age brackets made up 92% of the study population. Majority of the patients (49%) fell into the category of ASA IIE. Of the 110 indications for surgeries that were recorded, failure to progress accounted for 26 representing 23.6% just as Placenta Prevea followed with 10 cases making up 9.1%. Twenty cases (20%) were undertaken as elective while 80 (80%) were emergencies .Eight patients underwent GA with tracheal intubation making up 8% of the study population while the rest of the patients (92 [92%]) underwent sub-arachnoid block (SAB). Of the 42 complications observed, hypotension was encountered most occurring 23 times and making up 54.8%. Accordingly, administration of intravenous (IV) crystalloid along with IV ephedrine was undertaken 23 times representing 54.8%. Conclusion: The study revealed that the most preferred, anesthetic technique for caesarian section in this institution is sub-arachnoid block both for elective and emergency caesarian sections. This is because the technique is easier to perform than other regional techniques. Also, the employment of GA is not often recommended because of difficult airway issues. General anesthesia, not surprisingly, comes second. There is the need for more trained personnel and equipment to be made available so as to popularize the other regional techniques such as epidural and combined epidural-spinal (CES).

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