Anesthetic safety in pediatric urology: frequency, profile and factors associated with complication in Kinshasa.

Introduction Pediatric urological surgery poses unique anesthetic chal- lenges due to patients’ age, comorbidities, and procedural complexity. Limited data exist in sub-Saharan Africa re- garding anesthetic complications in this population. Objective: To describe the frequency, profile, and factors associated with anesthetic complications in pediatric uro- logical surgery at a reference center in Kinshasa. Methods A retrospective and analytical study was conducted from January 2011 to December 2024 at Monkole Mother and Child Hospital Center. Pediatric patients aged 0–15 years who underwent urological procedures under anesthesia were included. Data on demographics, clinical and surgi- cal characteristics, anesthetic management, and postoper- ative complications were extracted. Statistical analyses included univariate and multivariate logistic regression to identify factors associated with complications. Results Among 292 children, postoperative anesthetic complica- tions occurred in a subset of patients. Multivariate analy- sis identified significant predictors: presence of in- traoperative incident, difficult extubation, difficult awak- ening, general anesthesia with propofol, ASA 3 classifi- cation, difficult airways, higher body weight, and prior anesthetic history. Most patients were managed safely with low overall complication rates. Conclusion Anesthetic complications in pediatric urology are multi- factorial. Identification of high-risk patients, tailored an- esthetic management, and enhanced perioperative moni- toring can improve safety. These findings provide practi- cal guidance to optimize anesthetic care for children in resource-limited settings.