23 de fevereiro de 2016

Artigo recomendado: Providing Anesthesia Care in Resource-limited Settings

A 6-year Analysis of Anesthesia Services Provided at Médecins Sans Frontières Facilities

Promise Ariyo, Miguel Trelles, Rahmatullah Helmand, Yama Amir, Ghulam Haidar Hassani, Julien Mftavyanka, Zenon Nzeyimana, Clemence Akemani, Innocent Bagura Ntawukiruwabo, Adelin Charles, Yanang Yana, Kalla Moussa, Mustafa Kamal, Mohamed Lamin Suma, Mowlid Ahmed, Mohamed Abdullahi, Evan G. Wong, Adam Kushner, Asad Latif

Anesthesiology 2016;124:561-9

ABSTRACT

Background: Anesthesia is integral to improving surgical care in low-resource settings. Anesthesia providers who work in these areas should be familiar with the particularities associated with providing care in these settings, including the types and outcomes of commonly performed anesthetic procedures.

Methods: The authors conducted a retrospective analysis of anesthetic procedures performed at Médecins Sans Frontières facilities from July 2008 to June 2014. The authors collected data on patient demographics, procedural characteristics, and patient outcome. The factors associated with perioperative mortality were analyzed.

Results: Over the 6-yr period, 75,536 anesthetics were provided to adult patients. The most common anesthesia techniques were spinal anesthesia (45.56%) and general anesthesia without intubation (33.85%). Overall perioperative mortality was 0.25%. Emergent procedures (0.41%; adjusted odds ratio [AOR], 15.86; 95% CI, 2.14 to 115.58), specialized surgeries (2.74%; AOR, 3.82; 95% CI, 1.27 to 11.47), and surgical duration more than 6 h (9.76%; AOR, 4.02; 95% CI, 1.09 to 14.88) were associated with higher odds of mortality than elective surgeries, minor surgeries, and surgical duration less than 1 h, respectively. Compared with general anesthesia with intubation, spinal anesthesia, regional anesthesia, and general anesthesia without intubation were associated with lower perioperative mortality rates of 0.04% (AOR, 0.10; 95% CI, 0.05 to 0.18), 0.06% (AOR, 0.26; 95% CI, 0.08 to 0.92), and 0.14% (AOR, 0.29; 95% CI, 0.18 to 0.45), respectively.

Conclusions: A wide range of anesthetics can be carried out safely in resource-limited settings. Providers need to be aware of the potential risks and the outcomes associated with anesthesia administration in these settings.


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16 de fevereiro de 2016

Campanha Anestesia e Prevenção de Infecções - SMA



Campanha do Passo 1: Anestesia e Prevenção de Infecções do Programa "10 PASSOS PARA A ANESTESIA SEGURA", elaborada pelo Comitê de Qualidade e Segurança dos Serviços Médicos de Anestesia (SMA) de São Paulo.

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