Keywords
general anesthesia
perioperative complications
ASA physical status
mortality
How to Cite
Abstract
Introduction
General anesthesia in oral and maxillofacial surgery is essential for the management of complex or non-cooperative patients. However, it remains associated with significant morbidity and mortality, particularly in resource-limited settings.
Purpose
This study aimed to assess morbidity and mortality related to general anesthesia in odontostomatological surgery at the University Clinics of Kinshasa and to identify associated risk factors.
Methods
A retrospective analytical study was conducted among 418 patients who underwent odontostomatological surgery under general anesthesia. Sociodemographic, anesthetic, intraoperative, and postoperative data were collected and analyzed. Factors associated with mortality were identified using multivariate logistic regression analysis.
Results
The majority of patients were male (55.3%), and 30.6% were younger than 15 years. Patients classified as ASA III–IV accounted for 24.6% of cases. The most frequent intraoperative complications were hypoxemia (12.4%) and hypotension (10.5%). Postoperative complications included severe pain (23.4%) and postoperative nausea and vomiting (16.3%). The overall mortality rate was 5.0% (n = 21 deaths), including 2.15% anesthesia-related deaths, 1.44% deaths within the first 24 postoperative hours, and 1.44% between postoperative days 1 and 7. Seven-day survival was estimated at 95%. Independent predictors of mortality were ASA class ≥III (adjusted odds ratio [aOR] = 2.87, 95% confidence interval [CI] [1.62, 5.09], p < 0.001), difficult intubation (aOR = 3.41, 95% CI [1.78, 6.52], p < 0.001), emergency surgery (aOR = 2.11, 95% CI [1.18, 3.77], p = 0.011), and intraoperative hypoxemia (aOR = 2.95, 95% CI [1.71, 5.08], p < 0.001).
Conclusion
General anesthesia in odontostomatological surgery in Kinshasa is associated with high morbidity and considerable mortality, mainly related to respiratory complications and airway management difficulties. Strengthening perioperative monitoring and implementing standardized safety protocols are essential to improve patient outcomes.
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