Title : Morbi-mortalite anesthesique des nouveau-nes en post-operatoire immediat dans un pays a ressources limitees : cas de la republique democratique du Congo
Abstract:
Background: Immediate postoperative anesthetic morbidity and mortality of newborns refers to the medical complications and deaths that can occur in newborns in the period following surgery. It remains a major concern in developing countries where the technical platform is precarious. Most of the associated factors have been identified worldwide. The general objective is to identify the factors associated with anesthetic morbidity and mortality of newborns operated on in Kinshasa, capital of the Democratic Republic of Congo.
Methods: through a cross-sectional approach, which ran from January 2023 to January 2024, including newborns operated on for all causes at the University Clinics of Kinshasa. We described the epidemiological, therapeutic and evolutionary data in order to identify the different control factors to improve management. The collected data were analyzed using SPSS 26.0 software.
Results: A total of 73 newborns were collected from all patients operated on during the one-year period of
our study. The male sex was predominant with 71.2% of cases and the median age was 8 days old.
The youngest newborn was a few hours old and the oldest 30 days old. The indications
for surgery were anorectal malformations (19.1%), peritonitis (12.3%) and hydrocephalus (10.9%). Neonatal complications in the immediate postoperative period were dominated by desaturation (30%), bradycardia (12.5%), hemorrhage (12.5%) and delayed awakening (12.5%). As for the vital outcome: 49.3% survived while half of them (50.7%) died. Among which 32.9% died 24 hours after the intervention and 17.8% died within 24 hours after the intervention. The factors associated with morbidity and mortality were: the age of the newborn, intubation difficulties, delays between diagnosis and surgery, the qualification of the operators, the duration of the intervention as well as the occurrence of peroperative complications.
Conclusion: pediatric anesthetic morbidity and mortality in the first 24 hours in our environments remains
worrisome because of the many constraints, particularly organizational and socio-economic.
Prematurity, difficulty of intubation and peroperative complications are the factors associated with the fatal outcome of the operated.
Keywords: morbidity and mortality, postoperative, newborn, immediate and anesthetic
