Key result
Perioperative adverse events occur in ~42% of ENT and maxillofacial surgeries, concentrated at induction.
Why the study?
Adverse events of anesthesia in ENT and maxillofacial surgery and their risk factors were not well identified in the studied setting.
Cross-Sectional (n=200)
No
In a low-resource setting, anesthesia for ENT and maxillofacial surgery carries a high morbidity rate (42%), driven mainly by airway complications at induction and cardiovascular events.
Answers are grounded in this paper and cite their sources.
High adverse event rate during induction in ENT/maxillofacial anesthesia supports enhanced monitoring for emergent cases, ASA ≥2, and extreme ages; leaves open prospective validation of mitigation.
RÉSUMÉObjectif. Identifier les évènements indésirables de l’anesthésie en chirurgie oto-rhino-laryngologique et maxillo-faciale et les facteurs de risque. Patients et méthodes. Nous avons mené une étude transversale descriptive, du 9 avril au 7 décembre 2020, dans le service d’oto-rhino-laryngologie et chirurgie maxillo-faciale du Centre Hospitalier Universitaire Sylvanus Olympio de Lomé. Les évènements indésirables péri opératoires étaient relevés. Le données étaient analysées à l’aide du logiciel Epi info 3.5.4. Résultats. Deux cent patients d’âge moyen 28 ans ± 22 ans ont été inclus. La chirurgie était programmée dans 81%. Les patients étaient classés ASA1 (65%), ASA 2 (25%) et ASA 3 (10%). L’anesthésie générale était employée dans 100%. Au moins un évènement indésirable était survenu dans 42,0%. Les évènements indésirables à l’induction représentaient 42,5% : intubation difficile (19,5%), l’hypotension artérielle (8,5%), abord veineux difficile (4,0%) et laryngospasme (2,5%). Ceux de la phase d’entretien anesthésique représentaient 37,6% : hypothermie (11,5%), tachycardie (7,5%) et hypotension artérielle (5,5%). Ceux de la phase de réveil et postopératoire faisaient 19,9% : retard de réveil (8,5%), bronchospasme (2,5%), nausées et vomissements (2,5%). La chirurgie urgente (p< 0,001), les classes ASA ≥ 2 (p < 0,001), l’âge inférieur à 10 ans et supérieur à 60 ans (p = 0,004), et la durée d’anesthésie > 180 minutes (p<0,001) étaient associés à la survenue d’évènements indésirables. Conclusion. La morbidité de l’anesthésie en oto-rhino-laryngologie et chirurgie maxillo-faciale était liée aux complications survenant surtout à l’induction et dominées par les évènements indésirables respiratoires.ABSTRACTObjective. To identify the adverse events of anesthesia in ear, nose, throat and maxillo-facial surgery, and their risk factors. Patients and methods. We conducted a descriptive cross-sectional study from April 9 to December 7, 2020, in the of ENT and maxillo-facial surgery department of the Sylvanus Olympio University Hospital of Lomé. Perioperative adverse events were recorded. The data were analyzed using Epi info 3.5.4 software. Results. Two hundred patients aged 28 ± 22 years were included. The surgery was elective in 81%. Patients were classified as ASA1 (65%), ASA 2 (25%) and ASA 3 (10%). General anesthesia was used in 100%. At least one adverse event occurred in 42.0% of cases. Induction adverse events accounted for 42.5%: difficult intubation (19.5%), hypotension (8.5%), difficult venous access (4.0%) and laryngospasm (2.5%). Those of the maintenance period represented 37.6%: hypothermia (11.5%), tachycardia (7.5%) and hypotension (5.5%). Those of the recovery and postoperative period accounted for 19.9%: delayed recovery (8.5%), bronchospasm (2.5%), nausea and vomiting (2.5%). Emergent surgery (p<0.001), ASA grade ≥ 2 (p<0.001), age less than 10 years and greater than 60 years (p=0.004), and duration of anesthesia >180 minutes (p<0.001) were associated with the occurrence of adverse events. Conclusion. Morbidity of anesthesia in ear, nose, throat and maxillo-facial surgery was related to complications occurring mainly during induction period and were leaded by respiratory adverse events.
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Sarakawabalo et al. (2022) conducted a cross-sectional in Patients undergoing ear, nose, throat (ENT) and maxillofacial surgery (n=200). General anesthesia for ENT and maxillofacial surgery was evaluated on Occurrence of at least one perioperative adverse event. Perioperative adverse events occurred in 42.0% of patients during ENT and maxillofacial surgery, occurring mainly during the induction period, and were significantly associated with emergent surgery, ASA grade ≥ 2, extreme ages, and anesthesia duration >180 minutes.
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