Alagbe-Briggs O. T. and Onajin-Obembe B. O. I.
Ambulatory anaesthesia for paediatric surgery has n umerous benefits in appropriately selected patients. In rural surgical outreaches which consti tute unusual environments with peculiar challenges, a specialized anaesthesia practice can improve outc ome. This report highlights the experience of a specialized anaesthesia team in a rural surgical ou treach for paediatric day case inguinoscrotal surgeries by the Lagos State Ministry of Health, Ni geria. Following logistic preparations and pre- surgical screening, resolutions of the anaesthetic outreach team were documented, while demographic, surgical and anaesthesia records of paediatric pati ents billed for inguinoscrotal surgery at various health centres between March 2007 and March 2009 we re reviewed. These included types of surgery and anaesthesia as well as perioperative sequelae. Findings were documented and analysed using the SPSS v.16 software, and results presented as freque ncies and means ± standard deviation. A total of 535 patients aged 1-13yrs (mean-8±4.3) with M:F rat io of 4:1 were seen. With preoperative cancellation s in 25(4.7%), 510 patients were recruited. Surgical procedures were herniotomies 495(97.1%) and orchidopexies 15(2.9%). General anaesthesia was adm inistered using volatile agents in 340(66.7%) and ketamine as sole agent in 170(33.3%). Mean duration of anaesthesia was 37min±12.2. Intraoperative and postoperative sequelae occured in 8 (1.6%) and 49 ( 9.6%) patients respectively. No mortality or unanticipated admissions were recorded. Ambulatory anaesthesia for paediatric inguinoscrotal surgery offers advantages. Rural surgical outreaches are un usual settings with a need for high patient turnove r, but specialised anaesthesia teams observing safe pr actice can improve outcome.
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