Anesthetic management and morbidity in thoracic surgery: Results of the first series in Togo

Authors

  • Pikabalo Tchetike Department of Anesthesia and Intensive Care, Teaching Hospital Sylvanus Olympio, Lome, Togo
  • Damessane Lamboni Medico-surgical Clinic, Teaching Hospital Sylvanus Olympio (CHU-SO), Lome, Togo
  • Sarakawabalo Assenouwe Department of Anesthesia and Intensive Care, Faculty of Health Sciences, Teaching Hospital of Kara, University of Kara, Togo.
  • Magnoudewa Poko Medico-surgical Clinic, Teaching Hospital Sylvanus Olympio , Lome, Togo
  • Ernest Ahounou National University Hospital Centre of Cotonou, Benin
  • Amouki S. Tresor Anate Medico-surgical Clinic, Teaching Hospital Sylvanus Olympio , Lome, Togo
  • Kolme Dissoba Department of Anesthesia and Intensive Care, Teaching Hospital Sylvanus Olympio, Lome, Togo
  • Hamza Doles Sama Department of Anesthesia and Intensive Care, Teaching Hospital Sylvanus Olympio, Lome, Togo
  • Tabana Essohanam Mouzou Department of Anesthesia and Intensive Care, Faculty of Health Sciences, Teaching Hospital of Kara, University of Kara, Togo.

Keywords:

Thoracic surgery, pneumonectomy, anesthesia, One-lung ventilation, multimodal analgesia, morbidity, Togo, Africa

Abstract

Introduction: Thoracic surgery is a specialty with specific anesthetic management requirements. This is a recent specialty in Togo, with a multi-skilled anesthetic team.

Aim: To describe the anesthetic management and morbidity of thoracic surgery.

Methods: A descriptive, prospective and observational study was conducted on a cohort of patients who underwent a thoracic surgery between June 1 and August 31, 2022, at the national referral hospital in Lomé. The study examined pre-anesthetic assessment, surgical, anesthetic, and postoperative data.

Results: Twenty-five patients with a mean age of 40 ±13 years were included. The surgery was elective in 69% of cases. The anesthetic assessment showed anemia (64%) and a reduced forced expiratory volume in one second (60%)

All patients were operated on under general anesthesia with controlled ventilation, including 64% of one-lung ventilation. Surgical procedures included pleural decortication (28%), pericardial drainage (16%), pneumonectomy (16%), and pulmonary lobectomy (12%).  Twenty-three patients (92%) experienced intraoperative complications, including arterial hypotension (80%), shock (56%), and hypoxia (24%).

Multimodal analgesia including paracetamol (100%), nefopam (92%), morphine (76%), paravertebral analgesia (20%), and thoracic epidural analgesia (8%), was used postoperatively.

Seventeen patients (68%) experienced postoperative complications, including anemia (20%), pneumonia (12%), and parietal infection (12%). Three patients (12%) died.

Conclusion: General anesthesia with, one-lung ventilation in most cases, was the anesthetic technique in thoracic surgery. Complications, mainly cardiovascular, occurred intraoperatively, with high postoperative mortality.

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2023-09-27

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Vol. 101 No. 5 (2023): Tunis med may 2023

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