Preanesthetic Clinic Services: A Comparative Assessment of three Hospitals in Nigeria

Background: Preoperative assessment of surgical patients is the most vital aspect of the anaesthetist’s contributions to perioperative safety of the care of the surgical patient. In most developing countries, patients are evaluated by the anaesthetists few days or a day before the scheduled elective surgery and often at the bedside. The tendency to limit adequate assessment of all organ-systems, drug history or functional status is obvious and this is often corrected at a predetermined pre-operative clinic.

Aim: This study aims to evaluate the impact of preanesthetic clinics on patient safety and satisfaction in three hospitals in Nigeria.

Methods: This retrospective cross-sectional study analysed the records of 360 surgical patients who attended Preanesthetic Clinics (PACs) at three healthcare institutions in Nigeria:  The University of Port Harcourt Teaching Hospital (UPTH), Port Harcourt; the University College Hospital, Ibadan; and a high-volume private hospital in Port Harcourt. The study covered a five-year period from January 2020 to December 2024 and was conducted in accordance with ethical standards. Ethical approval was obtained from the State Ministry of Health and the respective institutional ethics committees prior to data retrieval. Quantitative data were analysed using IBM SPSS Statistics version 25.0 (IBM Corp., Armonk, NY, USA).

Results: Data for three hundred and sixty (360) patients were retrieved from the three hospitals as follows private hospital in Portharcourt (110) 30.6%, the UCH Ibadan (150) 41.7% and the UPTH (100) 27.8%.  Mean age was (range 3years.5mo – 82years). Females( 68.1%): male(31.9%). The commonest comorbidities identified were hypertension, diabetes and bronchial asthma. Commonest antiplatelet medication identified was clopidogrel. The implementation of PACs led to marked improvements in patient outcomes. Anxiety levels decreased significantly from 45% to 15%. Identification of risk factors increased from 20% to 80%. The incidence of surgery rescheduling dropped from 15% to 5%, while patient satisfaction rose from 50% to 90%.

Conclusion: The findings demonstrate that PACs are effective in enhancing surgical patient care. They contribute significantly to improving patient safety by reducing complications and anxiety, and increasing overall satisfaction. Therefore, the integration and expansion of PACs in surgical pathways are strongly recommended.