Anesthesia for non-cardiac surgery in obese patients in a secondary hospital located in an urban-rural area: A retrospective cohort study

Authors

  • Edwige Mombelek Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Wilfrid Mbomb Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Alphonse Mosolo Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Freddy Mbuyi Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Cong Author
  • Rémy Kashala Medical Management /Monkole Hospital Centre, Kinshasa, Democratic Republic of the Congo Author
  • Paul Kambala Surgery Department/Monkole Hospital Centre, Kinshasa, Democratic Republic of the Congo Author
  • Trésor Mapangul Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Kazi Ang Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Pascal Bayauli Internal Medicine Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Jean-bosco Kasiam Internal Medicine Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Aliocha Nkodil School of Public Health, University of Kinshasa, University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Emmanuel Namegabe Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Didier Djekembo Anesthesia and Intensive Care Department/Wallonie-Picarde Hospital Centre, Tournai/Belgique Author
  • John Nsiala Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Médard Bulabula Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author
  • Berthe Barhayiga Anesthesia and Intensive Care Department/Kinshasa University Clinics/University of Kinshasa, Kinshasa, Democratic Republic of the Congo Author

Keywords:

Anesthesia; obesity; noncardiac surgery; urban-rural setting

Abstract

Background and Objectives: Anesthesia in obese patients is associated with increased morbidity and mortality but has never been studied in our setting. This study investigated the complications associated with different grades of obesity.

Methods: This paper was a retrospective cohort study conducted from January 2011 to December 2024 at Monkole Hospital. Perianesthetic data from all obese adult patients anesthetized for non-cardiac surgery were collected and analyzed with SPSS 26.0 using appropriate statistical tests for p < 0.05. Ethical guidelines were respected.

Results: Of 13,226 anesthetized patients, 1,668 were obese (12.6%), including 1,162 (69.7%) moderately obese, 384 (23%) severely obese, and 122 (7.3%) morbidly obese. Cardiovascular comorbidities, difficulties with intubation and venous access, and hyperglycemia predominated in the morbidly obese. The morbidly obese patients significantly more frequently underwent major surgery and general anesthesia, using intubation, propofol, and suxamethonium. Intraoperative complications were more frequent in morbidly obese ORa 2.98 (2.29–3.86) and influenced by Mallampati grades II to IV ORa 1.63 (1.06–2.66), ASA4 class ORa 2.55 (1.06–6.24), and major surgical procedure ORa 2.70 (2.06–3.55). Obesity grade was not associated with mortality or postoperative complications, which included the following factors: the presence of a history of hematological disease (ORa 2.79 (1.7–3.78), ASA class 4 (ORa 3.09 (1.32–9.28), severe anemia (ORa 3.12 (2.11–4.21), hyperglycemia (ORa 3.92 (1.27–5.07), and major surgery (ORa 2.88 (1.84–3.85).

Conclusion: This study indicates that obese patients of all grades benefit from anesthetic procedures in our setting, and we need to improve their management. Intraoperative complications are more frequent in cases of morbid obesity, requiring us to double our attention in this type of patient.

Disclaimer: This article was originally published by WisdomGale Publishing, 14 Rue de Grand-Bigard, 1082 Brussels, Belgium, and was migrated to International Medical Publishing Group(IMPG), India after the change of Publisher.

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Published

2026-06-26

Issue

Vol. 2 No. Issue 3 (2025)

Section

Articles