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

Zoumenou, Eugène; Ndoye, Marie Diop; Tchaou, Blaise Adelin; N’Guessan, Y.F.; Kaboré, F.; Diango, Djibo M.; Chaibou, Maman Sani; Bula, Isokuma Bula; Essola, L; Otiobanda, Gilbert Fabrice; Brouh, Y.

doi:10.1016/j.anrea.2015.10.008

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…The frequency of combined inhalatory and intravenous induction was 45% in Cameroon 2019 and 55% in Togo 2016 [12]. Nze Obiang and co. in Gabon 2017 [11] and Niandou and co. at Niamey 2015 [6] instead reported a far elevated frequency of intravenous induction with respective proportions of 100% and 96.12%. These differences could be explained by local habits of each anaesthesia service and varied availability of drugs in each country.…”

Section: Anaesthesia Techniquementioning

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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Section: Anaesthesia Techniquementioning

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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“…[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%

“…2 Furthermore, proper postoperative pain management, considered a fundamental human right, 12 is generally insufficient. 7 Because the anatomical, physiological, and pharmacological characteristics of children make them more vulnerable, the consequences of inadequate management are high morbidity and mortality. In 2010, postoperative morbidity was 15.5% in Brazzaville, 9 with 156 perioperative cardiac arrests.…”

Section: Introductionmentioning

confidence: 99%

“…• training, to increase the number of anesthesiologists, and to give those practicing pediatric anesthesia specific skills through fellowships and training courses in pediatric anesthesia, 7,13 • development of pediatric hospitals whose surgical activity ensures that skills are maintained through exclusive and regular practice of pediatric anesthesia, 7…”

Section: Introductionmentioning

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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Compte rendu du 35e Congrès de l’Adarpef

Veyckemans

2015

Anesthésie & Réanimation

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

Cited by 5 publications

References 8 publications

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

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

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

Compte rendu du 35e Congrès de l’Adarpef

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