The Incidence of Post Operative Complications in the First 24 Hours Among Patients Undergoing Daycare Surgery at Kenyatta National Hospital.

Abstract

Back ground. Day care surgery and anesthesia rates have risen worldwide over the years in both developing and developed countries. This is made possible because of emergence of newer surgical, anesthetic and analgesic techniques and expanded scientific research in this field. Recovery and quality of care following day care surgery are key factors in its success, with delayed recovery due to various post-operative complications resulting in increased cost, reduced efficiency and unplanned admissions therefore having an overall negative impact on quality of care. Objective To determine the incidence of post-operative complications among patients undergoing day-care surgery at KNH within 24 hours. Study methodology. Consecutive sampling was carried out until a total of one hundred and twenty-four patients was achieved. The participants were recruited at the daycare surgical units after meeting the inclusion criteria. The patients were then followed throughout the intra-operative period and at Post Anesthesia Care Unit. Vital signs, post-operative complications, pain scores and time to achieve a standardized discharge criteria were recorded in PACU.Follow up information was obtained via telephone interviews 24 hours after discharge from the day care surgery unit. Results The Incidence of post-operative complications was 60% among 69 women and 47 adult men undergoing daycare operations at KNH.The commonest experienced complication was pain (49.1%) followed by nausea and vomiting (22.4%), with major associated factors identified as opioid use and type of anesthesia for pain and opioid use, mode of anesthesia and gender for PONV.Other adverse symptoms identified include bleeding, postoperative sore-throat, lightheadedness, bloating and urinary retention. The average length of stay in PACU was 50 minutes with 95% of patients having been discharged within 2 hours of surgery. There was a 0.9% incidence of unplanned admission with no return to hospital after discharge recorded. Conclusion: The result of this study confirm that a significant number of patients still experience pain and post discharge nausea and vomiting despite great improvements in management of the same. Therefore, Preoperative identification of associated risk factors for various complications among patients undergoing day care surgery is paramount in order to improve patient’s care.