Objective: Many surgical scoring systems are used to predict operative risk but most are complicated. The aim of the study was to determine the utility of the Surgical Apgar Score (SAS) in predicting post operative mortality and morbidity in general surgical cases.
Material and Methods: This was a prospective observational study. All adult patients for emergency and elective general surgical procedures were included. Intraoperative data was collected, and post operative outcomes were followed up till 30 days. SAS was calculated from intraoperative lowest heart rate, lowest MAP and blood loss.
Results: A total of 220 patients were included in the study. All consecutive general surgical procedures were included. Sixty of the 220 cases were emergency and the rest were elective. Forty-five (20.5%) of the patients developed complication. Mortality rate was 3.2% (7 out of 220). The cases were divided into high risk (0-4), moderate risk (5-8) and low risk (9-10) based on SAS. Complication and mortality rates were 50% and 8.3% in the high risk group, 23% and 3.7% in the moderate risk and 4.2% and 0 in the low risk group, respectively.
Conclusion: The surgical Apgar score is a simple and valid predictor of postoperative morbidity and 30-day mortality among patients undergoing general surgeries. It is applicable to all types of surgeries for emergency and elective cases and irrespective of the patient general condition and type of anesthesia and surgery planned.
IntroductionThis study aims to compare Lichenstein's repair performed under regional anaesthesia and local anaesthesia.
MethodsThis prospective study included two groups of 31 patients each with an uncomplicated inguinal hernia from surgical units of KMC affiliated hospitals. All patients underwent Lichenstein's tension-free repair either under spinal anaesthesia (group 1) or under local anaesthesia (group 2). Results from both groups were compiled and analysed.
ResultsMean age was 50.45 (SD 16.49) in group 1 and 50.61 (SD 12.04) in group 2. Median time taken for surgery was less under local anaesthesia (1.17 versus 1.5 hours). Postoperative pain was less in the local anaesthesia group at 24, 48 hours after surgery, and after 2 weeks of discharge. Group 1 had higher cases of urinary retention.
ConclusionLichenstein's repair under local anaesthesia was better concerning post-operative pain, complications and hospital stay.
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