Anaesthesia for orthopaedic surgeries in two tertiary institutions in north central Nigeria

Background: Orthopedic surgeries involve upper and lower extremities as well as spine surgeries and are performed under various anesthetic techniques. Therefore it is important to review the choice of anesthesia for the various orthopedic surgeries in order to evaluate their appropriateness. Method: A retrospective review of theatre records of all orthopedic surgeries performed over a 2 year period (1st July 2016-30th June 2018) involving patients of all ages was carried out in two tertiary institutions. Patient’s demographic data, site of surgery, the anesthetic technique used and duration of the surgery were recorded. Data were analyzed and presented as frequency and means using statistical package for social sciences (SPSS software version 23). Result: A total of 334 patients had orthopedic surgery done over the period under review. The mean age was 39 ± 20.9 years. More than sixty percent of the patients were males (60.8%). Most of the procedures were done as elective surgeries (61.7%). The sites of orthopedic surgical procedures done were upper limb 73 (21.9%), lower limb 243 (72.8%), upper and lower limb 4 (1.2%) and spine surgeries 14 (4.2%). Of the upper limb surgeries, 55 (75.3%) were performed under general anesthesia (GA) and 18 (24.7%) under regional anesthesia (RA). While for the lower limb, most of the surgeries were done under RA 196 (81%). The RA technique used was predominantly spinal 133 (54.7%) and GA cases were only 46 (19%). All the 14 spine surgeries were performed under GA. The upper and lower limb surgeries were done either as RA 2 (50%) or as GA+RA 2 (50%). Conclusion: Most of the upper limb surgeries that could be performed under regional anesthesia were done under GA, this has to improve. It is however commendable that a large proportion of lower limb surgeries were performed under various regional anesthetic techniques. There is a need to perform more spine surgeries under different anesthetic techniques.