An Appraisal of Anaesthesia for Abdominal Myomectomy in a Tertiary Institution in North-Central Nigeria
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Date
2024
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Zambia Medical Association
Abstract
Background: Abdominal myomectomy is a
common gynaecological surgical procedure in our
institution to remove uterine fibroids. This study
examined the anaesthetic technique and the
determinants of immediate postoperative
complications and outcomes.
Objective: A retrospective study of the various types
of anaesthetic techniques used and the immediate
post-operative/anaesthetic complications following
an open abdominal myomectomy.
Methods: This was a cross-sectional study of all
open abdominal myomectomies performed from 1st
January 2016 to 31st December 2019 at the
University of Ilorin Teaching Hospital. Data
collected included demographic data, anaesthetic
technique, uterine size, estimated blood loss and
postoperative outcomes and complications. Data
were analysed using Chi-square and Fisher's exact
test as appropriate using SPSS (IBM SPSS Statistics
version 22.0 Armonk, NY IBM Corp). A p-value of ?
0.05 was taken to be significant.
Results: Two hundred open myomectomies were
suitable for analysis. The mean age was 36.4±6.0
years and most patients were ASA I 102(51.0%).
Most of the surgeries were performed under regional
anaesthesia (RA) 130(65.0%) and 56(28.0%) under
general anaesthesia (GA) with 14(7.0%) converted
from RA to GA. The predominant RA used was
epidural anaesthesia 56(28.0%). Most of the patients
who had an estimated blood loss of greater than
2000mls 15(71.4) had GA p=0.000. Only one patient
1(0.5%) had an intraoperative cardiac arrest and was
resuscitated.
Conclusion: Regional anaesthesia for open
myomectomy is high in our institution with a very
good outcome, because of the availability of welltrained
personnel
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Keywords
Fibroids, Abdominal myomectomy, Anaesthesia techniques, Perioperative outcomes, Postoperative complications