Prevalence and factors associated with delayed recovery among adult patients undergoing elective surgery in main theatre of Mulago hospital.
Introduction: Delayed recovery is one where a patient takes a longer time than expected to recover from anesthesia. In this study Delayed recovery is one where one takes more than one hour to achieve Aldrete Score of nine and above. Delayed recovery leads to reduced patient turnover in theatre. In Mulago hospital delayed recovery could be a major factor in the unacceptably low surgical patient turns-over in theatres. Various factors contributing towards delayed recovery include patient, anesthetic and surgical factors. Objective: The objective of this study is to determine the prevalence of delayed recovery and factors associated with delayed recovery among adult patients undergoing elective surgery in Main theatre of Mulago Hospital. Methodology: Upon obtaining ethical approval, we performed a cross – sectional study. Eligible patients were consecutively recruited into the study. These included all consented adult patients admitted at Mulago Hospital and undergoing elective surgery in the Main theatre, belonging to an American Association of Anesthesiologist (ASA) physical status one or two. All those with neurological or organ diseases, or on medications that could alter their level of consciousness were excluded. Recruitment was done pre-operatively, data was collected in the perioperative period using a questionaire. Data analysis was done by using Stata version 10 and it included univariate and bivariate analyses. Univariate analysis revealed the prevalence of delayed recovery and this was done by presenting study participant characteristics as numbers and proportions in tables and graphs. Bivariate analysis revealed the relationship of outcome and factors associated. We used Logistic regression to compute the Crude odds ratio for the individual associations with the outcome. P value of < 0.05 was taken as statistically significant. Results: There were 1426 patients scheduled for elective surgery during the study period. 1004 patients were excluded and 422 patients were recruited, of these 82(19.4%) patients delayed to recover from anesthesia. Using a p-value of ≤ 0.05 to be statistically significant, the significant factors included: hypothermia, hypoglycemia, hyperglycemia, hypertension, diabetes mellitus, ASA 2, hypoxia, use of muscle relaxants, prolonged duration of surgery, and marked blood loss. Conclusions: The prevalence of delayed recovery in Main theatre of Mulago hospital was 19.4%. The factors associated with delayed recovery included hypothermia, hypoglycemia, hyperglycemia, hypoxia, hypertension, diabetes mellitus, ASA 2, prolonged duration of surgery, marked blood loss and use of muscle relaxants. Recommendations: The surgeons and anesthetists need to revise methods of minimizing hypothermia, blood loss, duration of surgery, and proper monitoring of patients intraoperatively. The anesthesia providers should revisit the proper use of muscle relaxants. There is need to do more studies to address the topic more comprehensively.