Co-relation of ASA-PS with post operative complications and morbidity in hysterectomy patients

Authors

  • Dushyant M. Nijhawan Department of Anaesthesiology, KDMC Hospital and Research Centre, Mathura, Uttar Pradesh, India
  • Jayshree J. Upadhye Department of Gynecology and Obstetrics, Rajshree Medical College, Bareilly, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20183447

Keywords:

Abdominal, ASA-PS, Hysterectomy, Surgical complications, Vaginal

Abstract

Background: Today, ASA grading is done for any surgical case performed under anesthesia. ASA PS is significantly associated with post-operative morbidity and mortality. For gynecologists, hysterectomy is the most common operation performed by gynecologists, next to caesarean section. The primary focus of this study was to review the ASA-PS of hysterectomy patients.

Methods: This retrospective study was performed in the department of Anesthesiology, in collaboration with Department of Obstetrics and gynecology. All women who underwent hysterectomy were included in this study.

Results: In this study, out of 100 patients, clinical indication was fibroid in 45 (45%) patients, menorrhagia in 15 (15%) patients, adenomyosis in 25 (25%) patients, uterovaginal prolapse in 5 (5%) patients, endometrial polyp in 5 (5%) patients and ovarian tumor in 5 (5%) patients. ASA-PS grade 1 was seen in 65 (65%) of patients, 25 (25%) of patients had ASA-PS grade 2, 10 (10%) of patients had ASA-PS grade 3 while none of the patients had ASA-PS grade 4 and 5. 4 (4%) patients had urinary tract infection, 2 (2%) patients had deep vein thrombosis, 1 (1%) patient had myocardial infarction and 1 (1%) patients had pneumonia. 25 (25%) patients were obese, 24 (24%) patients had diabetes, 20 (20%) patients had hypertension requiring treatment and 6 (6%) patients had wound infection.

Conclusions: ASA PS has strong, independent association with post-operative medical complications. This along with its simplicity, makes it a valuable prognostic metric.

References

American Society of Anesthesiologists. Guideline Summary: Practice advisory for preanesthesia evaluation. An updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Retrieved 1 April 2014.

Jump up Apfelbaum JL, Connis RT, Nickinovich DG, Pasternak LR, Arens JF, Caplan RA, Connis RT, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012;116(3):522-38 (PMID 22273990).

Gustafsson UO, Scott MJ, Schwenk W. Guidelines for perioperative care in elective colonic surgery: Enhanced Recovery After Surgery (ERAS(R)) society recommendations. Clin Nutr. 2012;31:783-800.

Practice Advisory for Preanesthesia Evaluation An Updated Report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation, Anesthesiology. March 2012;116(3).

Anesthesia Safety Checklist, World Health Organisation. Available at: www.who.int/surgery/publications/s15980e.pdf

Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Pre-Anaesthesia Consultation and Patient Preparation, PS07:2016.

Kumar HVR, Saraogi A, Parthasarathy S, Ravishankar M. A useful mnemonic for pre-anesthetic assessment. J Anaesthesi, Cli Pharmacol. 2013;29(4):560-1.

Mehta ST, Trivedi YN, Bhalodia P. Role of non-descent vaginal hysterectomy in advancing gynaecological practice. NHL J Med Scienc. 2014;3(1):55-8.

Pathak V, Singh P, Tripathi A. Retrospective analytical study of total abdominal hyeterectomy for benign gynaecological conditions. Int J Reprod Contracept Obstet Gynecol. 2017;6:1596-603.

Khunte V, Armo M, Gahne R, Sisodiya A, Verma S. Hysterectomy: still a treatment of choice for pelvic pathologies in rural India. Int J Reprod Contracept Obstet Gynecol. 2018;7:536-41.

Hackett NJ, De Oliveira GS, Jain UK, Kim JY. ASA class is a reliable independent predictor of medical complications and mortality following surgery. Int J Sur. 2015 Jun 1;18:184-90.

Araujo BL de C, Theobald D. Letter to the Editor: ASA Physical Status Classification in Surgical Oncology and the Importance of Improving Inter-Rater Reliability. J Kor Med Scien. 2017;32(7):1211-2.

Sankar A, Johnson SR, Beattie WS, Tait G, Wijeysundera DN. Reliability of the American Society of Anesthesiologists physical status scale in clinical practice Br J Anaesth, 2014;113:424-32.

Giannice R, Elvira F, Antonella P, Elisabetta M, Salvatore M, Giovanni S. Perioperative Morbidity and Mortality in Elderly Gynecological Oncological Patients (≥70 Years) by the American Society of Anesthesiologists Physical Status Classes, Annals of Surgical Oncology. February 2004;11:219.

Stepp KJ, Barber MD, Yoo EH, Whiteside JL, Paraiso MF, Walters MD. Incidence of perioperative complications of urogynecologic surgery in elderly women. Ame J Obs Gynecolo. 2005 May 1;192(5):1630-6.

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Published

2018-08-25

How to Cite

Nijhawan, D. M., & Upadhye, J. J. (2018). Co-relation of ASA-PS with post operative complications and morbidity in hysterectomy patients. International Journal of Research in Medical Sciences, 6(9), 2964–2968. https://doi.org/10.18203/2320-6012.ijrms20183447

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Section

Original Research Articles