%0 Journal Article
%T Peri-Anaesthetic Complications in Obese versus Non-Obese Patients in a Country with Limited Resources: Retrospective Cohort Study
%A Edwige Mombeleke
%A Wilfrid Mbombo
%A Alphonse Mosolo
%A Freddy Mbuyi
%A R&#233
%A my Kashala
%A Paul Kambala
%A Tr&#233
%A sor Mampangula
%A Pascal Bayauli
%A Jean Bosco Kaziam
%A Emmanuel Namegabe
%A Didier Ndjekembo
%A Joseph Nsiala
%A M&#233
%A dard Bula-Bula
%A Berthe Barhayiga
%J Open Journal of Anesthesiology
%P 88-113
%@ 2164-5558
%D 2025
%I Scientific Research Publishing
%R 10.4236/ojanes.2025.153008
%X <b>Background and </b><b>Rationale</b><b>:</b> Anaesthesia in obese patients is characterised by the occurrence of complications due to comorbidities and physiological and pharmacological changes caused by obesity. This study investigated complications in anaesthesia of obese versus non-obese patients in the not-always-optimal conditions of limited resources. <b>Methods</b><b>:</b> This was a retrospective cohort study conducted at Monkole Hospital from 01/01/2011 to 31/12/2023 in obese versus non-obese patients (one-to-one ratio) anaesthetised for all surgery, excluding cardiac surgery. Peri-anaesthetic data up to hospital discharge were collected ethically and analysed with SPSS 26.0 for p &lt; 5%. <b>Results</b><b>:</b> The sample comprised 2718 patients (1359 obese and 1359 non-obese). The mean age was comparable in both groups. A history of cardiovascular disease (p &lt; 0.001), respiratory disease (p = 0.028), diabetes (p = 0.001), difficult intubation (p &lt; 0.001), and difficult vascular access (p &lt; 0.001) predominated in the obese group. Pre-medication was more common in non-obese patients (p &lt; 0.001), propofol was more common in obese patients (p &lt; 0.001), obese patients were more frequently extubated on a table (p = 0.012), and postoperative morphine was more common in obese patients (p &lt; 0.001). Intraoperative complications (28.1% vs 21.4%, p = 0.001), intraoperative transfusion (13.4% vs 6.4%, p &lt; 0.001), and postoperative complications (10.9% vs 5.9%, p &lt; 0.001) were more frequent in obese patients. Mortality (2.72 vs 0.8%, p &lt; 0.04) was higher in obese patients. The factors associated with intraoperative complications were: obesity ORa 2.37 (1.47 - 3.84), female sex ORa 1.7 (1.27 - 3.0), hyperglycaemia ORa 1.66 (1.01 - 2.74), major surgery ORa 2.7 (1.01 - 3.15) and surgical duration of &#8805; two hours ORa 1.6 (1.42 - 2.62). Those associated with postoperative complications were obesity ORa 1.9 (1.3 - 2.78), ASA class III ORa 1.57 (1.03 - 2.37), ASA class IV ORa 3.21 (2.63 - 5.67), low prothrombin rate ORa 1.63 (101 - 2.64) and emergency ORa 1.52 (1.04 - 2.24). Factors associated with mortality were: obesity ORa 5.1 (2.21 - 7.5), impaired consciousness ORa 2.26 (1.44 - 4.36), ASA classes 3 and 4 respectively ORa 2.16 (1.8 - 4.28) and ORa 5.19 (3.98 - 8.47), intraoperative transfusion ORa 2.89 (1.9 - 3.98), surgical duration &#8805; two hours ORa 2.72 (1.56 - 4.68). <b>Conclusion</b><b>:</b> This study suggests that obesity is a risk factor for complications and mortality in anaesthesia, and therefore, the management
%K Complications
%K Anaesthetics
%K Obesity
%K Limited Resources
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=141451