Incidence and risk factors of Delayed emergence in surgical patients following general anesthesia at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia, 2024
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Date
2024-06
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Addis Ababa University
Abstract
Background: Delayed awakening can lead to various challenges in perioperative care, such as
prolonged hospital stays, increased healthcare costs, unexpected ICU admissions, reduced patient
satisfaction, and hindered postoperative care activities. However, there is scarce research on this
topic in our study area.
Objective: To evaluate the incidence as well as risk factors of delayed awakening among patients
undergoing surgery under general anesthesia at Tikur Anbesa Specialized Teaching Hospital.
Methods: A hospital-based cross-sectional study was conducted, involving 317 patients who
underwent surgery under general anesthesia at Tikur Anbesa Specialized Teaching Hospital from
May 1, 2023, to May 10, 2024. Data were collected and entered using epi info version 7 and
analyzed using SPSS version 27 after data cleaning. The association between categorical variables
was assessed using correlation and logistic regression. Odds ratios were calculated to determine
the associations through binary and multivariable logistic regressions.
Results: Out of the 317 patients included in the study, 31.2% experienced delayed awakening after
surgery. Multivariable logistic regression analyses indicated that smoking (AOR=0.056, 95%
CI:0.005-0.638), presence of medical comorbidity, premedication(AOR= 0.087,95% CI: 0.023-
0.333), intraoperative crystalloid administration >3L for adult patients(AOR =9.810 ,95% CI:
2.78-34.613), presence of intraoperative hypotension(AOR= 0.148 ,95% CI: 0.056-0.393), type
opioid at induction, duration of surgery ≥220minutes(AOR =5.815 , 95% CI:1.477-22.893),
duration of anesthesia ≥230minutes(AOR= 0.244 ,95% CI :0.066-0.905), moderate surgical risk
classification(AOR= 0.089 ,95% CI :0.018-0.426) and severe surgical risk classification (AOR
=0.049, 95% CI: 0.007-0.321) were the independent risk factors found to have a significant
association with delayed awakening (P<0.05).
Conclusion: Although it was single-center study, the number of patients experiencing delayed
awakening is substantial, and it has significant implications, including prolonged hospital stays,
increased healthcare costs, and adverse patient outcomes. It is clinically necessary to take early
countermeasures against such significant various risk factors to reduce the occurrence of delayed
awakening, and to improve the prognosis of patients. Multi-center studies are necessary to
determine the true impact on clinical patient outcomes and its economic impact to the national
level.
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Keywords
Delayed awakening, Anesthesia