Trends in Obstetric Anaesthesia in a Tertiary Hospital in Nigeria: A Four-Year Review

Abstract

Background: Obstetric anaesthesia has a vital role in the outcome of obstetric surgeries and in the past three decades, the pattern has changed from predominantly general anaesthesia to regional, mostly spinal, anaesthesia. The objective of this study was to investigate the trends in obstetric anaesthesia practice in a Federal Medical Centre and offer explanation for any change observed. Materials And Methods: This was a retrospective study of the obstetric anaesthesia unit of the department of anaesthesia and the labour ward of the hospital from 1stJanuary 2010 to 31st December,2013. Data extracted from the records included the age of the parturients, indications for surgery, types of Caesarean section, types of anaesthesia, the grade of anaesthetists, total deliveries and Caesarean section rates. Results: The totaldelivery for the period was 11,003 and the Caesarean section rate was 15.5%.In 2010 and 2011, general anaesthesia was the main type of anaesthesia accounting for 76.2% and 76.7% respectively. However, in 2012 there was a drastic reduction in the use of general anaesthesia to 33.5% while spinal rose from 23.3% in 2011 to 66.5% in 2012. By 2013, 70.9% of the cases were done under spinal while 29.1% were done under general anaesthesia.There was no mortality in 2010 and 2012. In 2011, there was 1 (0.2%) mortality and 3 (0.6%) in 2013. Conclusion: The first two years of the study revealed that most of the obstetric procedures were done under general anaesthesia and was predominantly practiced by Nurse Anaesthetists. The last two years showed predominant use of spinal anaesthesia. This was as a result of the arrival of a Consultant Anaesthetist. Training and retention of qualified physician practitioners is recommended.