撒哈拉以南非洲地区小儿门诊手术的麻醉：布基纳法索的一项试点研究。

Anesthesia for Ambulatory Pediatric Surgery in Sub-Saharan Africa: A Pilot Study in Burkina Faso.

作者信息

Kabré Yvette B, Traoré Idriss S S, Kaboré Flavien A R, Ki Bertille, Traoré Alain I, Ouédraogo Isso, Bandré Emile, Wandaogo Albert, Ouédraogo Nazinigouba

机构信息

From the *Pediatric University Hospital Charles De Gaulle, Ouagadougou, Burkina Faso; †University Hospital Yalagdo Ouedraogo, Ouagadougou, Burkina Faso; and ‡University Hospital Souro Sanou, Bobo Dioulasso, Burkina Faso.

出版信息

Anesth Analg. 2017 Feb;124(2):623-626. doi: 10.1213/ANE.0000000000001780.

DOI:10.1213/ANE.0000000000001780

PMID:28067703

Abstract

BACKGROUND

Long surgical wait times and limited hospital capacity are common obstacles to surgical care in many countries in Sub-Saharan Africa (SSA). Introducing ambulatory surgery might contribute to a solution to these problems. The purpose of this study was to evaluate the safety and feasibility of introducing ambulatory surgery into a pediatric hospital in SSA.

METHODS

This is a cross-sectional descriptive study that took place over 6 months. It includes all patients assigned to undergo ambulatory surgery in the Pediatric University Hospital in Ouagadougou, Burkina Faso. Eligibility criteria for the ambulatory surgery program included >1 year of age, American Society of Anesthesiologists (ASA) 1 status, surgery with a low risk of bleeding, lasting <90 minutes, and with an expectation of mild to moderate postoperative pain. The family had to live within 1 hour of the hospital and be available by telephone.

RESULTS

During the study period, a total of 1250 patients underwent surgery, of whom 515 were elective cases; 115 of these met the criteria for ambulatory surgery; 103 patients, with an average age of 59.74 ± 41.57 months, actually underwent surgery. The principal indications for surgery were inguinal (62) and umbilical (47) hernias. All patients had general anesthesia with halothane. Sixty-five percent also received regional or local anesthesia consisting of caudal block in 79.23% or nerve block in 20.77%. The average duration of surgery was 33 ± 17.47 minutes. No intraoperative complications were noted. All the patients received acetaminophen and a nonsteroidal anti-inflammatory drug in the recovery room. Twelve (11.7%) patients had complications in recovery, principally nausea and vomiting. Eight (7.8%) patients were admitted to the hospital.

CONCLUSIONS

No serious complications were associated with ambulatory surgery. Its introduction could possibly be a solution to improving pediatric surgical access in low-income countries.

摘要

背景

在撒哈拉以南非洲（SSA）的许多国家，手术等待时间长和医院容量有限是外科护理常见的障碍。引入门诊手术可能有助于解决这些问题。本研究的目的是评估在SSA的一家儿科医院引入门诊手术的安全性和可行性。

方法

这是一项为期6个月的横断面描述性研究。它包括所有在布基纳法索瓦加杜古的儿科大学医院被安排接受门诊手术的患者。门诊手术项目的入选标准包括年龄大于1岁、美国麻醉医师协会（ASA）1级状态、出血风险低、持续时间小于90分钟且预计术后疼痛为轻至中度的手术。患者家庭必须居住在距医院1小时车程内且能通过电话联系到。

结果

在研究期间，共有1250例患者接受了手术，其中515例为择期手术；这些患者中有115例符合门诊手术标准；103例平均年龄为59.74±41.57个月的患者实际接受了手术。手术的主要适应证是腹股沟疝（62例）和脐疝（47例）。所有患者均接受氟烷全身麻醉。65%的患者还接受了区域或局部麻醉，其中79.23%为骶管阻滞，20.77%为神经阻滞。平均手术时间为33±17.47分钟。未观察到术中并发症。所有患者在恢复室均接受了对乙酰氨基酚和一种非甾体抗炎药。12例（11.7%）患者在恢复过程中出现并发症，主要是恶心和呕吐。8例（7.8%）患者住院。