Practice of anesthesia in african environment: experience of the hospitals of Conakry, Guinea.

Abstract

To review the practice of anesthesia in Conakry hospitals This multicenter descriptive study focused on the practice of anesthesia in Conakry hospitals. We selected 9 healthcare facilities: 6 public and 3 private hospitals. Together, these hospitals had 23 operating theaters, of which 11 (47.8 %) had an anesthesia machine, while 12 (51.9 %) did not have an oxygen supply. Six (26.1 %) had a complete intubation platform. For monitoring, we observed a multiparametric scope in five (21.7 %) of the operating rooms and a pulse oximeter in five. The anesthesia products used most frequently were: ketamine (narcotic), fentanyl (opioid), vecuronium (neuromuscular blocking agent), halothane (volatile anesthetic), and bupivacaine (local anesthetic). These nine facilities have 51 professional anesthesia practitioners: 44 (86.27%) senior technicians in anesthesia-resuscitation, and 7 (13.73 %) physicians specialized in anesthesiology and resuscitation. Over a one-year period (2016), 6303 patients received anesthesia. Gynecology-obstetrical surgery accounted for the highest proportion of patients receiving anesthesia (43.47 %). General anesthesia without intubation was the most common anesthetic technique (67.5 %). Most incidents were intraoperative and cardiovascular (95.6 %). The mortality rate was 0.4 %. Better technical platforms and better training of young practitioners would improve the practice of anesthesia in Guinea.