Paediatric Cardiac Anaesthesia at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: The Hurdles, Struggles, and Successes

Abstract

Background: Open-heart surgery started at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife, Nigeria, 5 years ago through partnership with foreign partners. This paper reviewed the difficulties facing the development of paediatric cardiac anaesthesia, the pattern, and the outcome of cases managed.
 Methods: A review of the infrastructure, equipment, manpower and operational setup for open-heart surgery at OAUTHC was done. A retrospective study of all patients that were operated on from April 2016 to March 2021 was performed. Extracted data were analysed with Statistical Packages for the Social Scientists using descriptive statistics.
 Results: A total of 102 patients had open-heart surgeries during the period under review by the various teams in a shared facility of the hospital's main theatre. Challenges with manpower, infrastructure, and supplies were major limitations to service delivery. Most of the patients (75.5%) were aged < 5 years. The commonest procedures performed were ventricular septal defect closure (31.4%), total correction of tetralogy of Fallot (26.5%), and atrial septal defect closure (9.8%). Fast-tracked anaesthesia was used always except where it was contraindicated. Most (76.7%) of the cases were extubated within 24 hours after surgery; the mean (SD) duration of ventilation in the ICU was 0.99 (1.2) days and the average length of ICU stay was 3 days. The overall mortality rate was 20.6%.
 Conclusion: Numerous challenges confront the provision of sustainable paediatric cardiac anaesthesia services in resource-constrained settings like ours. Much can be achieved with appropriate investment in material and manpower, and partnership with experienced teams.
 Authors
 A T Adenekan 1, A M Owojuyigbe 1, O I Aaron 1, O O Ojo 2