Anesthetic management and morbidity in thoracic surgery: Results of the first series in Togo.

ABSTRACT

INTRODUCTION: Thoracic surgery is a specialty with specific anesthetic management requirements. This is a recent specialty in Togo, with a multi-skilled anesthetic team. AIM: To describe the anesthetic management and morbidity of thoracic surgery. METHODS: A descriptive, prospective and observational study was conducted on a cohort of patients who underwent a thoracic surgery between June 1 and August 31, 2022, at the national referral hospital in Lomé. The study examined pre-anesthetic assessment, surgical, anesthetic, and postoperative data. RESULTS: Twenty-five patients with a mean age of 40 ±13 years were included. The surgery was elective in 69% of cases. The anesthetic assessment showed anemia (64%) and a reduced forced expiratory volume in one second (60%) All patients were operated on under general anesthesia with controlled ventilation, including 64% of one-lung ventilation. Surgical procedures included pleural decortication (28%), pericardial drainage (16%), pneumonectomy (16%), and pulmonary lobectomy (12%). Twenty-three patients (92%) experienced intraoperative complications, including arterial hypotension (80%), shock (56%), and hypoxia (24%). Multimodal analgesia including paracetamol (100%), nefopam (92%), morphine (76%), paravertebral analgesia (20%), and thoracic epidural analgesia (8%), was used postoperatively. Seventeen patients (68%) experienced postoperative complications, including anemia (20%), pneumonia (12%), and parietal infection (12%). Three patients (12%) died. CONCLUSION: General anesthesia with, one-lung ventilation in most cases, was the anesthetic technique in thoracic surgery. Complications, mainly cardiovascular, occurred intraoperatively, with high postoperative mortality.