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Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin

Received: 10 November 2021    Accepted: 29 November 2021    Published: 11 December 2021
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Abstract

Introduction: The practice of pediatric anesthesia present particular risks and requires specifically trained staff. We describe here the practice of pediatric anesthesia in two referral hospitals of Cotonou. Method: This was an observational study conducted over a period of 05 months from August 4 to December 31, 2020. All children who had undergone an anesthetic procedure in these reference hospitals of Cotonou during the study period and who met the inclusion criteria were recruited. Data collection was carried out by filling out an individual physical form for each child on whom a surgery was performed. Children who underwent surgery were followed up until their discharge from hospital and called back 30 days later. Results: A total of 345 patients were registered. Among them, 224 (64.9%) were male, for a sex ratio of 1.85. The average age was 55 months±4 months with extremes of one day and 190 months. Medical history was found in 9.56% of cases, and in 80.90% of cases, most interventions were scheduled. Digestive surgery was the most common (30.1%). The ASA1 class was the most represented (73.04%). The practice of pediatric anesthesia was medicalized in 17.39% of cases. All children were monitored. General anaesthesia was the most commonly used anaesthesia technique (89.85%). Loco-regional anaesthesia techniques were less used (27.53%). Spinal anesthesia (11.90%) and caudal anesthesia (11.30%) were the most commonly used local anesthesia techniques. The prevalence of anesthetic incidents and/or accidents during our study was 23.7% with a rate of 29 cardiac arrests per 10,000 anesthetics and an intraoperative mortality rate of 29 per 10,000 anesthetics. Perioperative complications were dominated by respiratory complications (11.57%), followed by cardiovascular complications (8.68%) and neurological complications (6.95%). A total of 84.35% of our patients were referred to an immediate post-interventional monitoring unit. I recorded 13 deaths in the postoperative period, representing a mortality rate of 3.7%. Conclusion: This work shows that the practice of pediatric anesthesia in Benin compared to previous years is becoming more and more satisfactory, even if the anesthetic safety is not yet optimal. It seems imperative to favor the specialization of practitioners, to promote loco-regional anaesthesia and to create pediatric hospitals with adapted resuscitation rooms and operating theaters.

Published in American Journal of Pediatrics (Volume 7, Issue 4)
DOI 10.11648/j.ajp.20210704.17
Page(s) 219-224
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Pediatric Anesthesia, Referral Hospitals, Child, Cotonou - Bénin

References
[1] Zoumenou E, Gbenou S, Assouto P, Ouro bang’na, Lokossou Th, Hounnou G, Aguemon abdou rhaman, Chobli M. Pediatric anesthesia in developing countries: experience in the two main university hospitals of Benin in West Africa. Pediatric Anesthesia 2010 20: 741–747.
[2] Bosenberg AT. Pediatric anesthesia in developing countries. Curr Opin Anaesthesiol 2007; 20: 204–210.
[3] Hodges SC, Walker IA, Bosenberg AT. Paediatric anaesthesia in developing countries. Anaesthesia 2007; 62 (Suppl. 1): 26–31.
[4] Murat I, Rigouzzo A. Les risques de l’anesthésie pédiatrique. 6e éd. Paris: Elsevier Masson; 2005. P. 11-28.
[5] Benkhalifa S, Dehdouh A, Hmamouchi B, Trifa M, Hassen A. Anesthésie pédiatrique au Maghreb: formation, pratique et obstacles. Ann Fr Anesth Reanim 2010; 29 (4): 576-8.
[6] Zoumenou E, Ndoye MD, Tchaou B, Nguessan F, Kaboré F, Diango D, et al. Pratique de l’anesthésie chez l’enfant en Afrique francophone subsaharienne. État des lieux et perspectives d’amélioration. Anesth Reanim 2015; 1 (6): 512-6.
[7] Otiobanda GF, Mahoungoun KCG, Freitas NK, Odzebe KWS, Ekouya GB, Mandavo CN. Pratique de l’anesthésie pédiatrique au centre hospitalier et universitaire de Brazzaville. Rev Afr Anesth Med Urg 2011; 16 (1): 1-6.
[8] Ouro-Bang NM, Kabore RAF, Zoumenou E, Gnassingbé K, Chobli M. Anesthesia for children in Sub-Saharan Africa - a description of settings, common presenting conditions, techniques and outcomes. Pediatr Anesth 2009; 19 (1): 5-11.
[9] Zoumenou E, Gbenou S, Assouto P, Ouro-Bang NM, Lokossou T, Hounnou G, et al. Pediatric anesthesia in developing countries: experience in the two main university hospitals of Benin in West Africa: pediatric anesthesia in developing countries. Pediatr Anesth 2010; 20 (8): 741-7.
[10] Amengle A, Bengono R, Mbengono JM, Zambo A, Esiene A, Minkande JZ. Complications per et postopératoires en anesthésie pédiatrique dans deux hôpitaux de la ville de Yaoundé. Rev Afr chir 2019; 13 (1): 21-6.
[11] Obiang PCN, Nguema PN, Ngomas JF, Obame R, Essola L, Zue AS. Evaluation de la sécurité en anesthésie pédiatrique dans un hôpital régional au Gabon. Bull Med Owendo 2019; 17 (47): 18-21.
[12] Mouzou T, Egbohou P, Tomta K, Sama H, Assenouwe S, Akala Y, et al. Pratique de l’anesthésie pédiatrique dans un pays en développement: expérience du CHU Sylvanus Olympio de Lomé au Togo. Rev Afr Anesthésiol Med Urg 2016; 3 (21): 38-42.
[13] Niandou M, Foumakoye A, Moustapha H, Ada OA, Bawa MB, Idrissa A, et al. Pratique de l’anesthésie pédiatrique à l’hôpital national Lamordé de Niamey. Rev Afr Anesthésiol Med Urg 2015; 20 (4): 1-134.
[14] Graaf JC, Sarfo MC, Wolfswinkel LV, Werff DBM, Schouten ANJ. Anesthesia-related criticals incidents in the perioperative period inchildren; a proposal for an anesthesia-related reporting system for critical incidents in children. Pediatr Anesth 2016; 26 (12): 7-43.
[15] Baujard C, Roulleau P. Anesthésie pour chirurgie ambulatoire en pédiatrie. Pr Anesth Réanim 2005; 9 (3): 209-25.
[16] Guellec V, Orliaguet G. Anesthésie du nourrisson et de l’enfant. 36e éd Paris: Elsevier Masson; 2011.
[17] Taibi H, Hmamouch B, Lazraq M, Semlal F, Yaqin K, chlilek A. Pratique de l’anesthésie pédiatrique au Maroc. Ann Fr Anesth Réanim 2014; 33 (21): 56-61.
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Cite This Article
  • APA Style

    Akodjènou Joseph, Mewanou Serge, Ahounou Ernest, Lalèyè Yasmine, Zoumenou Eugène, et al. (2021). Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin. American Journal of Pediatrics, 7(4), 219-224. https://doi.org/10.11648/j.ajp.20210704.17

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    ACS Style

    Akodjènou Joseph; Mewanou Serge; Ahounou Ernest; Lalèyè Yasmine; Zoumenou Eugène, et al. Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin. Am. J. Pediatr. 2021, 7(4), 219-224. doi: 10.11648/j.ajp.20210704.17

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    AMA Style

    Akodjènou Joseph, Mewanou Serge, Ahounou Ernest, Lalèyè Yasmine, Zoumenou Eugène, et al. Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin. Am J Pediatr. 2021;7(4):219-224. doi: 10.11648/j.ajp.20210704.17

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  • @article{10.11648/j.ajp.20210704.17,
      author = {Akodjènou Joseph and Mewanou Serge and Ahounou Ernest and Lalèyè Yasmine and Zoumenou Eugène and Gbénou Séraphin Antoine and Fiogbé Michel Armand},
      title = {Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin},
      journal = {American Journal of Pediatrics},
      volume = {7},
      number = {4},
      pages = {219-224},
      doi = {10.11648/j.ajp.20210704.17},
      url = {https://doi.org/10.11648/j.ajp.20210704.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20210704.17},
      abstract = {Introduction: The practice of pediatric anesthesia present particular risks and requires specifically trained staff. We describe here the practice of pediatric anesthesia in two referral hospitals of Cotonou. Method: This was an observational study conducted over a period of 05 months from August 4 to December 31, 2020. All children who had undergone an anesthetic procedure in these reference hospitals of Cotonou during the study period and who met the inclusion criteria were recruited. Data collection was carried out by filling out an individual physical form for each child on whom a surgery was performed. Children who underwent surgery were followed up until their discharge from hospital and called back 30 days later. Results: A total of 345 patients were registered. Among them, 224 (64.9%) were male, for a sex ratio of 1.85. The average age was 55 months±4 months with extremes of one day and 190 months. Medical history was found in 9.56% of cases, and in 80.90% of cases, most interventions were scheduled. Digestive surgery was the most common (30.1%). The ASA1 class was the most represented (73.04%). The practice of pediatric anesthesia was medicalized in 17.39% of cases. All children were monitored. General anaesthesia was the most commonly used anaesthesia technique (89.85%). Loco-regional anaesthesia techniques were less used (27.53%). Spinal anesthesia (11.90%) and caudal anesthesia (11.30%) were the most commonly used local anesthesia techniques. The prevalence of anesthetic incidents and/or accidents during our study was 23.7% with a rate of 29 cardiac arrests per 10,000 anesthetics and an intraoperative mortality rate of 29 per 10,000 anesthetics. Perioperative complications were dominated by respiratory complications (11.57%), followed by cardiovascular complications (8.68%) and neurological complications (6.95%). A total of 84.35% of our patients were referred to an immediate post-interventional monitoring unit. I recorded 13 deaths in the postoperative period, representing a mortality rate of 3.7%. Conclusion: This work shows that the practice of pediatric anesthesia in Benin compared to previous years is becoming more and more satisfactory, even if the anesthetic safety is not yet optimal. It seems imperative to favor the specialization of practitioners, to promote loco-regional anaesthesia and to create pediatric hospitals with adapted resuscitation rooms and operating theaters.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Practice of Pediatric Anesthesia in Sub-Saharan Africa: Experience of Two Referral Hospitals in Benin
    AU  - Akodjènou Joseph
    AU  - Mewanou Serge
    AU  - Ahounou Ernest
    AU  - Lalèyè Yasmine
    AU  - Zoumenou Eugène
    AU  - Gbénou Séraphin Antoine
    AU  - Fiogbé Michel Armand
    Y1  - 2021/12/11
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajp.20210704.17
    DO  - 10.11648/j.ajp.20210704.17
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 219
    EP  - 224
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20210704.17
    AB  - Introduction: The practice of pediatric anesthesia present particular risks and requires specifically trained staff. We describe here the practice of pediatric anesthesia in two referral hospitals of Cotonou. Method: This was an observational study conducted over a period of 05 months from August 4 to December 31, 2020. All children who had undergone an anesthetic procedure in these reference hospitals of Cotonou during the study period and who met the inclusion criteria were recruited. Data collection was carried out by filling out an individual physical form for each child on whom a surgery was performed. Children who underwent surgery were followed up until their discharge from hospital and called back 30 days later. Results: A total of 345 patients were registered. Among them, 224 (64.9%) were male, for a sex ratio of 1.85. The average age was 55 months±4 months with extremes of one day and 190 months. Medical history was found in 9.56% of cases, and in 80.90% of cases, most interventions were scheduled. Digestive surgery was the most common (30.1%). The ASA1 class was the most represented (73.04%). The practice of pediatric anesthesia was medicalized in 17.39% of cases. All children were monitored. General anaesthesia was the most commonly used anaesthesia technique (89.85%). Loco-regional anaesthesia techniques were less used (27.53%). Spinal anesthesia (11.90%) and caudal anesthesia (11.30%) were the most commonly used local anesthesia techniques. The prevalence of anesthetic incidents and/or accidents during our study was 23.7% with a rate of 29 cardiac arrests per 10,000 anesthetics and an intraoperative mortality rate of 29 per 10,000 anesthetics. Perioperative complications were dominated by respiratory complications (11.57%), followed by cardiovascular complications (8.68%) and neurological complications (6.95%). A total of 84.35% of our patients were referred to an immediate post-interventional monitoring unit. I recorded 13 deaths in the postoperative period, representing a mortality rate of 3.7%. Conclusion: This work shows that the practice of pediatric anesthesia in Benin compared to previous years is becoming more and more satisfactory, even if the anesthetic safety is not yet optimal. It seems imperative to favor the specialization of practitioners, to promote loco-regional anaesthesia and to create pediatric hospitals with adapted resuscitation rooms and operating theaters.
    VL  - 7
    IS  - 4
    ER  - 

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Author Information
  • Resuscitation Anesthesia Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin

  • Hubert Koutoukou Maga National Teaching Hospital Center, Abomey-Calavi University, Cotonou, Benin

  • Hubert Koutoukou Maga National Teaching Hospital Center, Abomey-Calavi University, Cotonou, Benin

  • Resuscitation Anesthesia Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin

  • Hubert Koutoukou Maga National Teaching Hospital Center, Abomey-Calavi University, Cotonou, Benin

  • Resuscitation Anesthesia Department, Mother and Child Teaching Hospital Lagoon, Abomey-Calavi University, Cotonou, Benin

  • Hubert Koutoukou Maga National Teaching Hospital Center, Abomey-Calavi University, Cotonou, Benin

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