Practice of Pediatric Anesthesia in an Adult Operating Theater in Sub-Saharan Africa: Experience of the Essos Hospital Center in Yaounde (Cameroon)

Abstract

Background: The aim of this study was to evaluate the practice of pediatric anesthesia in an adult operating theater in sub-Saharan Africa. Patients and Methods: This was an observational, prospective descriptive study that took place over a period of 12 months in the anesthesiology department of the Essos hospital center in Yaounde (Cameroon). Children <15 years old, seen in anesthesia consultation and operated on for scheduled surgery during the above- mentioned period were included in the study. The variables studied were the variables studied were: the characteristics of the study population, the anesthetic and surgical data, as well as the patient's postoperative itinerary. Results: During the study period, 162 patients were included out of a total of 1205 patients operated on during the same period. The median age was 5 years, the sex ratio 1.8. ASA class 1 was the most represented (98.1%). The combination midazolam and atropine was the premedication of choice (87.1%). General anesthesia was the most practiced technique (96.3%). Induction of general anesthesia was inhalation in 69% of cases, sevoflurane was the hypnotic used in this indication. General anesthesia was performed by a senior anesthesiologist in 67.3% of children. The majority of surgical procedures belonged to otolaryngology surgery (57%). The electrocardiogram (ECG), blood pressure, SpO2 and heart rate constituted the main part of the intraoperative monitoring. Conclusion: In low-income countries, pediatric anesthesia is still performed by personnel who are not specialized in pediatric anesthesia. In order to improve the safety of children in the operating room, health policies must encourage training and specialization in this highly delicate area, which will make it possible to reduce perioperative infant morbidity and mortality.