DOI: 10.36347/sjams.2020.v08i12.003

Pages: 2694-2698

Objective: Evaluation of anesthetic practices during emergency cesarean sections at the regional hospital of Saint Louis in Senegal. Patients and methods: Prospective, descriptive and analytical study of 4 months (from February 1st to May 31st, 2019) including all patients who had an emergency caesarean section. The parameters studied were: age of patients, history and condition of patients, number of pregnancy and childbirth, preoperative clinical and paraclinical evaluation data, indication for surgery, types of surgery, anesthesia data, intraoperative incidents and accidents, postoperative complications, fetal and maternal morbidity. The data have been input and analyzed with the software Epi Info version 7.2.3.0. Results: We collected a total of 195 patients. The average age was 27 years (Extremes: 15 - 45 years). The preoperative evaluation found a score of ASA 1 in 41%, ASA 2 in 31.7%, and ASA 3 in 21% of cases. The initial Glasgow coma scale was 15 in 96% of cases, and variable consciousness disorders were noted in 4% of cases. Pre-operative hypertension was reported in 35% of cases and hypotension in 2.6% of cases. Anemia with a hemoglobin level < 11 g/dl was noted in 25% of cases. Patients received an average of 1400 ml of crystalloids (Extremes: 500 to 2000 ml). Feto-pelvic dystocia, vascular and renal syndromes and acute fetal distress were indications for Caesarean section in 49%, 28% and 25% of cases respectively. Spinal anesthesia was the anesthetic technique in 90.3% of cases. Intraoperative complications were hypotension, bradycardia and hemorrhage, which were mostly found during general anesthesia. Conclusion: The choice of anesthetic technique must consider the degree of urgency, the maternal and fetal condition. In rural Africa, our study has revealed that, beyond scientific recommendations, organizational, environmental factors and the equipment participate in the choice of the anesthetic technique.