Does implementation of preanesthesia assessment clinics improve surgical patients care in Nigeria?

Abstract

Introduction: Preanesthesia assessment of patients is a major component of the perioperative care of surgical patients. The benefits of outpatient preoperative assessment clinics (PAC) were recognized over 67 years ago. However, these clinics are not used in Nigeria as part of surgical care. Search of the literature did not reveal any hospital in Nigeria that operates PAC, and therefore, its implementation in this country is still in process. This may not be unconnected with scarce financial, material, and human resources. Materials and Methods: This study was a questionnaire survey of the views of anesthetists, surgeons, and hospital administrators in some Nigerian Federal Teaching Hospitals on the usefulness and limitations of PAC. Structured questionnaires were sent to surgeons, anesthetists and Chairmen, Medical Advisory Committees in the selected Hospitalsand the results were analyzed. Results: Respondents indicated the benefits of preanesthesia assessment clinics as decrease in the incidence of surgery delays and cancelations, shorter lengths of hospital stay, improvement in the logistics of preoperative preparation, improved patient knowledge of anesthesia, and preoperative care as well as the role of the anesthetist in surgical care. Limiting factors to successful preanesthesia clinics were lack of cooperation from anesthetists and surgeons, other medical specialists, lack of supporting staff, finance, and appropriate office space. Conclusions: Preanesthesia assessment clinic increases the overall efficiency of the period of stay of the surgical patient in the hospital. Its benefits outweigh its disadvantages, and its successful implementation requires effort, time, money, and close collaboration with hospital administrators.