Abstract
L’objectif était de relever les aspects anesthésiologiques et les complications périopératoires des méningiomes intracrâniens opérés au CHU Sylvanus Olympio de Lomé (CHU SO). Il s’agissait d’une étude rétrospective sur dossiers de patients opérés de méningiomes intracrâniens durant la période de Décembre 2010 à décembre 2015 (5 ans) au CHU SO. 21 (45,6%) méningiomes recensés sur 46 tumeurs cérébrales opérées. Age moyen: 49 ± 20 ans; prédominance masculine (52,4%), ratio M/F: 1,1. Classification ASA: ASA II: 16 patients, ASA III: 4 patients, et ASA IV: 1 patient. L’anesthésie a été intraveineuse totale avec du Propofol (100%) comme hypnotique et du fentanyl (76,2%) comme morphinique le plus disponible. Complications peropératoires: saignement, pertes sanguines moyennes: 1750 ± 584 ml; hypotension avec Pression artérielle moyenne (PAM) < 60 mmHg: 10 (47,6%) patients; choc hémorragique 2 (9,5%) patients, arrêt cardiocirculatoire: 01(4,7%) patient réanimé avec succès. Complications postopératoires: convulsions 5 (23,8%) cas, hyperthermie 4 (19%) cas, choc hémorragique 2(9,5%) cas, décès: 2 (9,5%) cas. La morbidité et la mortalité périopératoire de la chirurgie du méningiome intracrânien au CHU SO de Lomé reste élevée. L’amélioration du plateau technique et une consultation précoce permettrait de réduire ces complications.
English abstract
This study aimed to point to both the anesthesiological aspects and the perioperative complications of intracranial meningiomas operated at the Sylvanus Olympio University Hospital Center, Lomé. We conducted a retrospective study by reviewing the medical records of patients with intracranial meningiomas undergoing surgery over the period December 2010-December 2015 (5 years) at the Sylvanus Olympio University Hospital Center, Lomé. Out of 46 patients operated fo brain tumors, 21 (45.6%) had meningioma. The average age was 49 ±20 years, with a male predominance (52.4%) and a sex ratio (M/F) of 1.1. Patients were classified according to ASA classification: 16 patients were classified as ASA II, 4 patients as ASA III and 1 patient as ASA IV. Patients underwent total intravenous anesthesia using hypnotic agent such as propofol (100%) and fentanyl (76.2%), which was the most available opioid. Perioperative complications were: bleeding, ( mean blood loss: 1750 ±584 ml), hypotension (mean arterial pressure (MAP) < 60 mmHg) in 10 (47.6%) patients; hemorrhagic shock in 2 (9.5%) patients, cardiovascular arrest: 01 (4.7%) patient successfully resuscitated. Postoperative complications were: convulsions in 5 (23.8%) cases, hyperthermia in 4 (19%) cases, hemorrhagic shock in 2 (9.5%) cases, death in 2 (9.5%) cases. Perioperative morbidity and mortality associated with intracranial meningioma surgery at the Sylvanus Olympio University Hospital Center, Lomé remains high. Improvement of technical equipment and early consultation should reduce these complications.
Key words: Intracranial meningiomas, anesthesia, complications, Sylvanus Olympio University Hospital Center, Togo