Department Anesthesia and Critical Care, University of Botswana, Gaborone, Botswana.
Anesthesia, Critical Care, and Emergency Medicine department, University of Rwanda, Kigali, Rwanda.
PLoS One. 2023 Dec 19;18(12):e0295932. doi: 10.1371/journal.pone.0295932. eCollection 2023.
Little is known about the regional anesthesia practice in low resources settings (LRS). The aim of this study was to describe the regional anesthesia capacity, characteristics of regional anesthesia practice, and challenges and solutions of practicing safe regional anesthesia in public hospitals in Botswana.
This was a cross-sectional survey of anesthesia providers working in public hospitals in Botswana. A purposive sampling method of public hospitals was used to achieve representation of different hospital levels across Botswana. Paper-based questionnaires were sent to anesthesia providers from selected hospitals. Descriptive statistics were used for analysis.
Questionnaires were distributed to 47 selected anesthesia providers from selected hospitals; 38 (80.9%) were returned. Most participants were nurse anesthetists and medical officers (57.8%). All hospitals perform spinal anesthesia; however, other regional techniques were performed by a small number of participants in one referral hospital. Most hospitals had adequate regional anesthesia drugs and sedation medications, however, most hospitals (except one referral hospital) lacked ultrasound machine and the regional anesthesia kit. The common challenges reported were lack of knowledge and skills, lack of equipment and supplies, and lack of hospital engagement and support. Some solutions were proposed such as regional anesthesia training and engaging the hospital management to get resources.
The results of this study suggest that spinal anesthesia is the most common regional anesthesia technique performed by anesthesia providers working in public hospitals in Botswana followed by few upper limb blocks. However, most public hospitals lack enough training capacity, equipment, and supplies for regional anesthesia. More engagement of the hospital management, investment in regional anesthesia resources, and training are needed in order to improve the regional anesthesia capacity and provide safe surgery and anesthesia in Botswana.
在资源有限环境（LRS）中，人们对区域麻醉实践知之甚少。本研究旨在描述博茨瓦纳公立医院的区域麻醉能力、区域麻醉实践特点以及实施安全区域麻醉的挑战和解决方案。
这是一项针对博茨瓦纳公立医院麻醉师的横断面调查。采用公立医院的目的抽样方法，以代表博茨瓦纳不同级别的医院。从选定的医院向麻醉师发送纸质问卷。采用描述性统计方法进行分析。
从选定的医院向 47 名选定的麻醉师分发了问卷，其中 38 名（80.9%）返回。大多数参与者是护士麻醉师和医师（57.8%）。所有医院均行脊髓麻醉，但少数参与者在一家转诊医院行其他区域技术。大多数医院有足够的区域麻醉药物和镇静药物，但大多数医院（除一家转诊医院外）缺乏超声机和区域麻醉套件。报告的常见挑战包括知识和技能缺乏、设备和用品缺乏以及医院参与和支持缺乏。提出了一些解决方案，例如区域麻醉培训和让医院管理层参与以获取资源。
本研究结果表明，脊髓麻醉是博茨瓦纳公立医院麻醉师最常进行的区域麻醉技术，其次是少数上肢阻滞。然而，大多数公立医院缺乏足够的区域麻醉培训能力、设备和用品。需要医院管理层更多的参与、对区域麻醉资源的投资和培训，以提高区域麻醉能力，为博茨瓦纳提供安全的手术和麻醉。
