Pediatric Anesthesia in Developing Countries

Bösenberg, Adrian

doi:10.1016/b978-0-323-42974-0.00051-3

Cited by 5 publications

(3 citation statements)

References 124 publications

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“…[ 2 , 16 , 24 ] These two components – a Spanish speaking visiting team member and opportunities to simulate the treatment process – allowed challenging operations to be taught, deeply understood, and performed, even with only one Spanish speaking team member. [ 3 , 17 , 22 ] While this communication barrier may appear to be a problem for virtual events at an international scale, the development and utilization of an internationally recognized communication protocol for neurosurgeons can resolve this issue. Just as there is a parliamentary procedure to guide formal discussion productively, a virtual platform communication protocol between neurosurgeons can be framed so that for every major statement made by a speaker, time is made available for translation.…”

Section: Discussionmentioning

confidence: 99%

Optimizing international neurosurgical outreach missions: 15-year appraisal of operative skill transfer in Lima, Peru

Jandial

Narang

Brun

et al. 2021

Surgical Neurology International

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Background: While several medical outreach models have been designed and executed to alleviate the unmet need for international neurosurgical care, disparate strategies have evolved. There is a need to determine the optimal pediatric neurosurgical outreach model through which resources are efficiently utilized while imparting the largest possible impact on global health. This study evaluates the efficacy of an international pediatric neurosurgery outreach model at transferring operative skill in a sustainable and scalable manner in Lima, Peru over a 15-year duration. Methods: Three 1-week neurosurgical missions were carried out (2004–2006) in Lima, Peru to teach neuroendoscopic techniques and to provide equipment to host neurosurgeons, equipping the hosts to provide care to indigent citizens beyond the duration of the missions. Follow-up data were obtained over a 15 year span, with collaboration maintained over email, two in-person visits, and video-conferencing services. Results: Since the outreach missions in 2004–2006, the host neurosurgeons demonstrated sustainability of the neuroendoscopic instruction by independently performing neuroendoscopic operations on a growing caseload: at baseline, 0 cases were performed in 2003, but since 2012 and onwards, 40–45 cases have been performed annually. Scalability is illustrated by the fact that the institution established a rigorous neuroendoscopy training program to independently pass on the techniques to resident physicians. Conclusion: The described international pediatric neurosurgical outreach model, centered around teaching operative technique as opposed to solely providing care to citizens, allowed operative skill to be sustainably transferred to surgeons in Lima, Peru. Having served the neuroendoscopic needs of hundreds of citizens, the strategic design is replicable and should be mirrored by future medical endeavors seeking to substantially impact the deficit in global surgical care.

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Section: Discussionmentioning

confidence: 99%

Optimizing international neurosurgical outreach missions: 15-year appraisal of operative skill transfer in Lima, Peru

Jandial

Narang

Brun

et al. 2021

Surgical Neurology International

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“…In developing countries of the world, children are contained more than 50% of the population with younger than 18 years old. From these, it has been projected that 85% of the children possibly will requisite some kind of surgical intervention before their 15th years of adolescent period [ 1 ]. Surgical pediatric admission labeled with 6–12% of entire pediatric admission, even though numerous of their admissions were included to somewhat minor surgeries [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

“…The safe provision of anesthesia depends on preexisting condition of the child. However, the preoperative investigation availability is limited in rural areas of low and middle income countries [ 1 ]. Furthermore, the harmless practice of pediatric anesthesia is mainly related to appropriate sized face mask, tracheal tubes, oropharyngeal airways, laryngoscope and intravenous cannula, but there is less accessibility of these crucial equipment [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative pediatric mortality in Ethiopia: A prospective cohort study

Tarekegn

Seyoum

Abebe

et al. 2021

Annals of Medicine &Amp; Surgery

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Background There was recording of excellent outcomes for pediatric surgery in developed countries of the world when it was carried out by an experienced pediatric surgeon and anesthetists with availabilities of equipment. However, this circumstance was not the ordinary for developing countries. The main objective of our study was to launch a pediatric perioperative mortality rate reference point and determination of associated factors under general or regional anesthesia in Ethiopia. Materials and methods the prospective electronic based data collection was done at Tibebe Ghion Specialized Teaching Hospital, Ethiopia with case specific of perioperative data for age less than 18 years old. We computed patients with mortality at 24 h, 48 h and 7 days in the form of percentages. Logistic regression was used for evaluation of mortality at different predictor variables. Results from 849 cases analyzed, there were mortality rate of 0.59%, 1.42%, and 2.58% within 24 h, 48 h and 7 days of surgery, respectively. The emergency surgeries (OR = 2.80 [95% CI, 1.78–3.82]; p < 0.03) were associated with an increased risk of mortality within 7 days of post-surgery. Conclusion Despite the progresses reached in the pediatric anesthesia and surgical safety in Tibebe Ghion Specialized Teaching Hospital, the pediatric perioperative mortality rates were still high or comparable to other low income African countries. Emergency surgeries were associated with an increased risk of perioperative mortality within 7 days of surgical intervention. Tibebe Ghion Specialized Teaching Hospital should emphasis on evaluation and monitoring of outcome for reduction of mortality with the emergency surgeries younger than 18 years old. We also suggested doing this research work at larger sample sizes for more actual information.

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