Perioperative fluids management in elective major surgeries at Butare University Teaching Hospital in Rwanda

Abstract

Background: Globally over 312 million surgical operations are performed annually and the association between poor perioperative fluids management and postoperative mortality was reported and postoperative mortality and morbidity was high in poor perioperative fluid management. The perioperative goal-directed fluid strategy may reduce postoperative complications among patients undergoing major surgery. Methodology: The quantitative prospective design was applied to achieve the research objectives. The sample size of 133 patients operated in theatre of Butare University Teaching Hospital was used, representing the study population of 200 patients per month. A convenient sampling method was used in the present study. The SPSS 21 was used to capture and analyze the data; both descriptive and inferential statistics was applied to assess the associations among various variables. Results: The analysis of the findings from this study revealed the positive association between fasting period and dehydration status among patients underwent elective surgery at Butare University teaching hospital. The results show that 108 (81.2%), and 71(53%) are in class A of hydration status before and after surgery respectively, while 25 (18.8%), and 62(46.6%) are in class B before and after surgery respectively. The reason for being dehydrated after surgery was established to be due to long period of fasting before patients came to theatre including the time patient passed in surgical procedure and anesthesia. In this study Fasting for 12-18 hours was predominant with proportions of 72.9%.Over a quarter of the sample had comorbidity with the subject for surgery 26.3%. Conclusion: This study revealed that patients operated at Butare University teaching hospital, were dehydrated in class B after surgery. The management of perioperative fluid is critically ineffective which cause the patients to be dehydrated after surgery. There is a need to improve the management of perioperative fluid for avoiding the complications related to ineffective administration and to continue to train the perioperative nurses in Rwanda for improving the practices in perioperative fluid management.