Background: The aim of this study was to evaluate the practice of pediatric anesthesia in an adult operating theater in sub-Saharan Africa. Patients and Methods: This was an observational, prospective descriptive study that took place over a period of 12 months in the anesthesiology department of the Essos hospital center in Yaounde (Cameroon). Children <15 years old, seen in anesthesia consultation and operated on for scheduled surgery during the above- mentioned period were included in the study. The variables studied were the variables studied were: the characteristics of the study population, the anesthetic and surgical data, as well as the patient's postoperative itinerary. Results: During the study period, 162 patients were included out of a total of 1205 patients operated on during the same period. The median age was 5 years, the sex ratio 1.8. ASA class 1 was the most represented (98.1%). The combination midazolam and atropine was the premedication of choice (87.1%). General anesthesia was the most practiced technique (96.3%). Induction of general anesthesia was inhalation in 69% of cases, sevoflurane was the hypnotic used in this indication. General anesthesia was performed by a senior anesthesiologist in 67.3% of children. The majority of surgical procedures belonged to otolaryngology surgery (57%). The electrocardiogram (ECG), blood pressure, SpO2 and heart rate constituted the main part of the intraoperative monitoring. Conclusion: In low-income countries, pediatric anesthesia is still performed by personnel who are not specialized in pediatric anesthesia. In order to improve the safety of children in the operating room, health policies must encourage training and specialization in this highly delicate area, which will make it possible to reduce perioperative infant morbidity and mortality.
Background: Clonidine stimulates the α2 receptors of the sympathetic nervous system which have a negative presynaptic feedback effect inducing a reduction in the secretion of adrenaline and noradrenaline. The main objective of our study was to evaluate the beneficial effects of clonidine on the hemodynamic response to surgical incision. Patients and Methods: This was a prospective, single-center, randomized, single-blind clinical trial that took place over a period of 4 months in the anesthesia department of the Essos hospital center in Yaoundé. All patients over the age of 18, ASA I or II, admitted for scheduled surgery were included in the study. The patients were randomly divided into two groups by drawing lots: group A (clonidine) and group B (non-clonidine). All patients in group A received clonidine IV (3μg/kg). Heart rate, systolic blood pressure, and diastolic blood pressure were observed at different times during the surgical procedure. Results: During the study period, 35 met the inclusion criteria: 20 patients for group A and 15 patients for group B. The average age was 34 years. The sex ratio was in favor of the male gender in both groups: 2.3 in group A and 2.7 in group B. ASA class 1 was the most represented (74.3%); visceral surgery most performed of all specialties in the two groups 55% (n=11) for group A and 53% (n=8) for group B. The systolic and diastolic arterial pressure curves are parallel in the two groups. There is a slight variation in PAS and PAD in group A "clonidine" compared to the baseline values. A tendency towards systolic arterial hypertension is observed in the “non-clonidine” control group. The heart rate remains stable in group A, while tachycardia is observed at the same time for the participants in group B. Conclusion: Clonidine is an alpha 2 adrenergic receptor agonist which makes it possible to limit the hypersecretion of catecholamines, potentially deleterious for the fragile patient, at the surgical incision.
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