Retrospective analysis of anesthesia service for earthquake-stricken in Nepal

Abstract

Objective. Retrospective analysis of anesthesia service while rescuing specialized surgical and traumatological operation for earthquakestricken in Nepal (2015). Materials and methods . Team of Russian doctors of GBUZ NII NDHiT DZ of Moscow rescued specialized medical operation for earthquake-stricken in Nepal from 30.04.2015 to 18.05.2015. The team sonsisted of 7 doctors: 2 surgeons, 2 traumatologists, 1 neurosurgeon and 2 anesthesiologists. The last ones performed 235 anesthesia at 59 patients (32 adults at the age of 36 ± 14 years and 27 children at the age of 7,5 ± 4 years with different surgical pathology). Results . From the whole number of anesthesia, there were 98 (41,7 %) inhalational anesthesia; 44(18,7 %) intravenous anesthesia; 39 (16,6 %) combined (intravenous and inhalational with regional anesthesia); 36 (15,3 %) regional anesthesia; 18 (7,7 %) endotracheal anesthesia. At the phase of wound process preparation to plastic closing at children, mostly intravenous and inhalational anesthesia were used, and regional anesthesia at adults. At the phase of plastic closing of soft-tissue defects endotracheal or combined anesthesia were used. In presence of orthopedic trauma and reposition with osteosynthesis combined anesthesia was used - intravenous or inhalational anesthesia with regional anesthesia, endotracheal anesthesia in combination of epidural one. Infusion therapy, antibacterial therapy, anticoagulation reversal and anaesthesis were provided to all patients. Complications at anesthesia: arterial hypotension – 12 (5,1 %), “agitation” after anesthesia with Sevoflurane – 32 (13,6 %), long postanesthesia respiratory depression – 2 (0,9 %). No lethal outcomes. Conclusions . It’s up to anesthesiologist to choose the type of anesthesia, it depends on timelines of surgical help, seriousness of the case, combination, extensiveness and trauma localization.