Adverse events during general anesthesia at the university hospital center (CHU) “Hôpital du Mali”
Authors:   Department of Anaesthesia, Resuscitation and Emergency Medicine, ", Sidibé A ,   Mali Hospital",   University Hospital, Bamako (Mali), Beye SA ,   Anaesthesia and Resuscitation Department at the Mohamed VI Perinatal Clinic in Bamako (Mali), Koureïssi Tall F ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, Kati University Hospital (Kati), Sanogo SB ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Diallo B ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, Point G University Hospital, Bamako (Mali), Dramé AI ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Tembiné K ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Coulibaly B ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Traoré A ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Traoré F ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Traoré MA ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Touré T ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Coulibaly M ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali), Kéita B ,   International Center for Excellence in Research, Mali (ICER-Mali)/ University of Science, Technology and Technology of Bamako (USTTB) Mali, Koné J ,   Faculty of Medicine and Odonto-Stomatology (Bamako)/ University of Science, Technology and Technology of Bamako (USTTB) Mali, Sangaré M ,   International Center for Excellence in Research, Mali (ICER-Mali)/ University of Science, Technology and Technology of Bamako (USTTB) Mali, Diani N ,   Department of Anaesthesia, Resuscitation and Emergency Medicine, "Mali Hospital" University Hospital, Bamako (Mali)
Published: September 2024

Objective: To evaluate the incidence of adverse events during general anesthesia and to describe their progression. Methodology: Cross sectional study with retrospective collection over 6 months at the Mali Hospital University Hospital. It included all patients who underwent elective or urgent surgeries under general anesthesia (GA) with tracheal intubation. Vital parameters and details of incidents and accidents were collected and analyzed. Results: During the study period, 723 anesthesia procedures were performed, of which 339 were GA, a prevalence of 46.9%. Among these patients, 149 (43.9%) experienced at least one AE. The mean age was 28 ± 19.9 years old [3 days old; 85 years old], with a sex ratio ~1. AEs occurred during elective anesthesia in 68.4%. The primary surgical specialties were thoracic/cardiovascular surgery (40.4%) and neurosurgery (37.8%). Patients were classified as American Society of Anesthesiologists-2 (ASA 2) in 49.5%. Pharmacological premedication was administered in 84.7%. The intravenous hypnotics used included propofol (85.5%), thiopental (8%), and ketamine (6.5%). Inhalation agents used were isoflurane (99.4%) and halothane (0.6%). Vecuronium (95.5%) was the most commonly used muscle relaxant, while suxamethonium (4.5%) was used for intubation. AEs predominantly occurred during induction and maintenance of anesthesia, with hypotension (84.6%), desaturation, hypertension, and cardiac arrest being the most common. Delayed awakening was observed in 5.6%, including one instance of unrecovered cardiac arrest (0.6%). The overall mortality rate due to AEs was 0.6%. Conclusion: Adverse events are common during GA, particularly during induction and entretien phases, and are associated with a mortality rate of 0.6%. Keywords: Adverse events, GA, Incidence, Mali.