Anaesthetic practices at Yaounde (Cameroon).

This descriptive and prospective study, carried out during a 6-month period at Yaounde (Cameroon), assessed work practices relating to anaesthesia in public and private health care institutions, the incidence and causes of complications, and considers possible means for improving security of the anaesthetized patient. This study included 1,103 patients, aged 12 days to 89 years. Main surgical indications were gynaecology-obstetrics (33.3% of cases) and emergency surgery (28.6% of cases). Anaesthetic practices were characterized by an unsuitable and non systematic use of procedures which are essential parts of a safe anaesthetic. Pre-anaesthetic assessment was carried out in 71.4% of cases, premedication in 78.4% of cases and management in recovery room in 24% of cases only. Patients were anaesthetized by nurses in 78.6% of cases (40% of them had been trained on-the-job only). The anaesthesia equipment of operating room was poor in most places, especially with respect to physiological monitors. The rate of complications, 476 in 321 patients (29.1% of cases), was similar to the incidence registered in 1977 (30%). Twenty-four deaths occurred (overall mortality rate of 2.2%). Besides the shortage of equipment, this study underlines the necessity for producing and adhering to guidelines for safe practice of anaesthesia, adapted for developing countries. (C) 1999 Elsevier, Paris.