AUDIT OF OBSTETRIC ANAESTHESIA SERVICES IN A NIGERIAN TERTIARY HOSPITAL.

Abstract

Background: Obstetric anaesthesia is an important anaesthesia subspecialty. The challenges presented by parturients requiring anaesthesia, analgesia, or both make the role of the obstetric anaesthetist both challenging and rewarding. This audit was undertaken to review obstetric anaesthesia services at the University College Hospital, Ibadan, over 2 years and thus identify areas for improvement. Methods: This was a two-year retrospective, cross-sectional study of obstetric anaesthesia services at University College Hospital, Ibadan. Data were collected from the anaesthesia record and entered into an Excel spreadsheet. The collected data included age, American Society of Anesthesiology (ASA) class, type and urgency of surgery, anaesthetic technique, outcomes, and critical incidents. Data was analysed using the Python programming language within the Jupyter Notebook environment. Results: One thousand eight hundred and seventy anaesthetics were administered at the labour ward complex during this period, with 93.3% being for caesarean deliveries. The majority of patients were classified as ASA II. Previous caesarean delivery was the most common indication for surgery, accounting for approximately a quarter of the reasons. Of these procedures, 92.4% were performed under subarachnoid block (SAB), while 6.7% were conducted under general anaesthesia. Only four patients received labour epidural analgesia (LEA). The immediate post-operative outcome was satisfactory in nearly all cases. Hypotension was the most frequently reported intraoperative critical incident. Conclusion: Subarachnoid block remains the major anaesthetic technique in obstetric anaesthesia. However, minimal labour epidural analgesia is being provided.