Anesthésie pédiatrique au Maghreb : formation, pratique et obstacles

Khalifa, S. Ben; Dehdouh, A.; Hmamouchi, B.; Trifa, Mehdi; Hassen, A. Fekih

doi:10.1016/j.annfar.2010.05.027

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…However, major analgesics such as morphine and nalbuphine are still not widely available and contribute to the poor pain management reported in the postoperative period. 6 enables practitioners to gain experience and practice on a more regular basis, thereby improving the quality of care. 14 Investing in healthcare facilities is one of the goals of sustainable development.…”

Section: Discussionmentioning

confidence: 99%

“…There is an increasing use of drugs known to be safer, such as sevoflurane, as opposed to halothane. However, major analgesics such as morphine and nalbuphine are still not widely available and contribute to the poor pain management reported in the postoperative period 6 . Some highly recommended equipment, such as capnography, and warming devices, are still not widely available.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] In most African countries, children constitute about 50% of the population, and about 85% of them will need surgery before their 15th birthday. 5 In addition, several studies have highlighted that in Africa, pediatric anesthesia is mostly performed by non-physician anesthesia providers, [6][7][8][9][10] in general hospitals, 10,11 in the absence of adequate drugs and equipment. 2 Furthermore, proper postoperative pain management, considered a fundamental human right, 12 is generally insufficient.…”

Section: Introductionmentioning

confidence: 99%

“…French-speaking Africa's Society of Anesthesia and Intensive Care (SARAF) should formulate local standards. It is also necessary to create a fellowship in pediatric anesthesia and intensive care in this region, and to promote short courses such as the pediatric SAFE course.Charles de Gaulle Pediatric University Hospital, Ouagadougou, Burkina Faso 2 Tengandogo University Hospital, Ouagadougou, Burkina Faso 3 Albert Royer/UCAD Children's Hospital, Dakar, Senegal 4 Sourô Sanou University Hospital, Bobo-Dioulasso, Burkina Faso 5 Donka Hospital, Conakry, Guinea6 Gabriel Touré University Hospital, Bamako, Mali Equipment available in hospitals in 12 French-speaking SSA countries.…”

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confidence: 99%

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Advances in pediatric anesthesia services over the past 10 years in French‐speaking sub‐Saharan Africa

Ki,

Sanou,

Ndoye Diop

et al. 2024

Pediatric Anesthesia

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IntroductionTo improve and maintain quality and safety in anesthesia, standards have been proposed regarding human resources, facilities and equipment, medications and intravenous fluids, monitoring, and the conduct of anesthesia. Compliance with these standards remains a challenge in French‐speaking sub‐Saharan Africa (SSA) and results in high morbidity and mortality particularly in children.This aim of this study was to assess the progress made in improving the pediatric anesthesia infrastructures, human resources, education, medications, and equipment in French‐speaking SSA over the past 10 years (2013–2022).MethodsThis is a descriptive, multicenter, cross‐sectional study with retrospective data collection, conducted from September 1 to November 5, 2023. Comparative data from 2012 to 2022 were collected through an online survey. Descriptive statistics were used to summarize data.ResultsData were obtained from 12 countries out of 14. The number of hospitals providing pediatric surgery and anesthesia rose from 94 in 2012 to 142 in 2022 (+51%). The total number of physician anesthesiologists rose from 293 (0.1 physician anesthesiologists/100 000 inhabitants) in 2012 to 597 (0.2 physician anesthesiologists/100 000 inhabitants) in 2022 (+103.7%). Five (0.006 physician anesthesiologists/100 000 children) had completed a fellowship in pediatric anesthesia and intensive care in 2012, and 15 (0.01 physician anesthesiologists/100 000 children) in 2022 (+200%). Five physician anesthesiologists had an exclusive pediatric anesthesia practice in 2012, whereas they were 32 in 2022 (+540%). There is no specialized training in pediatric anesthesia and intensive care in any of these countries. Halothane was always available in 81.5% of the hospitals in 2012, and in 50.4% of the hospitals in 2022. Sevoflurane was always available in 5% of the hospitals in 2012, and in 36.2% in 2022. Morphine was always available in 32.2% in 2012, whereas it was available in 52.9% of them in 2022. Pediatric pulse oximeter sensors were available in 36% of the hospitals in 2012, and in 63.4% in 2022. Capnography was available in 5.3% of the hospitals in 2012, and in 48% in 2022.ConclusionProgress have been made over the last 10 years in French‐speaking SSA to improve infrastructures, human resources, education, medications, and equipment for pediatric anesthesia in French‐speaking SSA. However, major efforts must be continued. Standards adapted to the local context should be formulated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Advances in pediatric anesthesia services over the past 10 years in French‐speaking sub‐Saharan Africa

Ki,

Sanou,

Ndoye Diop

et al. 2024

Pediatric Anesthesia

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“…In Maghreb, Benkhalifa and co. [5], in 2010, have addressed pediatric anesthesia practice with focus on training, practices and obstacles. It was then shown that pediatric anesthesia in that region was practiced by unspecialized personnel.…”

Section: Introductionmentioning

confidence: 99%

Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin

Joseph¹,

Serge²,

Ernest³

et al. 2021

AJP

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Introduction: The practice of pediatric anesthesia present particular risks and requires specifically trained staff. We describe here the practice of pediatric anesthesia in two referral hospitals of Cotonou. Method: This was an observational study conducted over a period of 05 months from August 4 to December 31, 2020. All children who had undergone an anesthetic procedure in these reference hospitals of Cotonou during the study period and who met the inclusion criteria were recruited. Data collection was carried out by filling out an individual physical form for each child on whom a surgery was performed. Children who underwent surgery were followed up until their discharge from hospital and called back 30 days later. Results: A total of 345 patients were registered. Among them, 224 (64.9%) were male, for a sex ratio of 1.85. The average age was 55 months±4 months with extremes of one day and 190 months. Medical history was found in 9.56% of cases, and in 80.90% of cases, most interventions were scheduled. Digestive surgery was the most common (30.1%). The ASA1 class was the most represented (73.04%). The practice of pediatric anesthesia was medicalized in 17.39% of cases. All children were monitored. General anaesthesia was the most commonly used anaesthesia technique (89.85%). Loco-regional anaesthesia techniques were less used (27.53%). Spinal anesthesia (11.90%) and caudal anesthesia (11.30%) were the most commonly used local anesthesia techniques. The prevalence of anesthetic incidents and/or accidents during our study was 23.7% with a rate of 29 cardiac arrests per 10,000 anesthetics and an intraoperative mortality rate of 29 per 10,000 anesthetics. Perioperative complications were dominated by respiratory complications (11.57%), followed by cardiovascular complications (8.68%) and neurological complications (6.95%). A total of 84.35% of our patients were referred to an immediate post-interventional monitoring unit. I recorded 13 deaths in the postoperative period, representing a mortality rate of 3.7%. Conclusion: This work shows that the practice of pediatric anesthesia in Benin compared to previous years is becoming more and more satisfactory, even if the anesthetic safety is not yet optimal. It seems imperative to favor the specialization of practitioners, to promote loco-regional anaesthesia and to create pediatric hospitals with adapted resuscitation rooms and operating theaters.

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Pratique de l’anesthésie chez l’enfant en Afrique francophone subsaharienne. État des lieux et perspectives d’amélioration

Zoumenou

Ndoye

Tchaou

et al. 2015

Anesthésie & Réanimation

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Anesthésie pédiatrique au Maghreb : formation, pratique et obstacles

Cited by 3 publications

References 11 publications

Advances in pediatric anesthesia services over the past 10 years in French‐speaking sub‐Saharan Africa

Advances in pediatric anesthesia services over the past 10 years in French‐speaking sub‐Saharan Africa

Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin

Pratique de l’anesthésie chez l’enfant en Afrique francophone subsaharienne. État des lieux et perspectives d’amélioration

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