Articles

Anaesthesia-Related Child Mortality in a Niger Delta Tertiary Hospital: 5-Year Impact of Paediatric Anaesthesia Training

/in /by

Background: A rising under-five perioperative death occurring especially in sub-Saharan Africa, despite global decline in child mortality over the last decade, necessitates a review of the contribution from anaesthesia-related causes.

Objective: To analyze the 5-year impact of Paediatric Anaesthesia Fellowship on anaesthesia-related child deaths in the University of Port Harcourt Teaching Hospital (UPTH).

Method: A five-year survey of all anaesthetic interventions and outcomes in children aged 0 to 5 years, in UPTH, was undertaken. Data including general or loco-regional anaesthesia for elective/emergency surgeries, sedation-analgesia for diagnostic radiology, the indications, perioperative critical events/child deaths up to 24 hours following anaesthesia, and their causes, were obtained from the registers and records of the relevant units in the UPTH, after ethical approval.

Results: Totally, 1596 anaesthetic interventions [987 (61.842%) electives; 609 (38.158%) emergencies] and outcomes were reviewed. General anaesthesia with endotracheal tube (GA + ETT) placement was the most frequent form of anaesthesia, administered to 1,075 (67.36%), and perioperative laryngospasm [49 (3.07%)] was the ranking critical event, followed by hypoxaemia, delayed recovery and difficult tracheal intubation respectively as the second, third and fourth, with the corresponding values of 34 (2.13%), 33 (2.07%) and 25 (1.57%); anaesthesia-related mortality was 1 (0.06%), occurring postoperatively from respiratory failure, following GA + ETT placement for elective abdominoplasty in a child with Prune-belly Syndrome.

Conclusion: Within the five-year period in this survey, anaesthesia-related child mortality was 1 (0.06%), occurring postoperatively from respiratory failure.

A Prospective Survey on Adequacy of Information Conveyed to Consenters Prior to Obtaining an Informed Consent for Anaesthesia

/in /by

Background: Ensuring adequate information conveyance to consenters prior to obtaining consent for anaesthesia is an ethical necessity.

Objective: To ascertain the adequacy of information conveyed to consenters prior to obtaining informed consent for anaesthesia, in the University of Port Harcourt Teaching Hospital (UPTH).

METHOD: Ethical clearance secured and written consent obtained, 385 subjects, aged ≥18 years, were served questionnaires addressing 19 points totally, 5 of which (section A) elicited socio-demographic data, while 14 (section B) assessed the comprehensiveness and adequacy of information conveyed prior to obtaining consent. A “yes, very much” option score ≥80%, or combined “yes, very much” and “yes, but little” options score ≥90%, was considered adequate information in each of the 14 points addressed in section B.

Results: There was less than 80% score of the “yes, very much” option, and  <90% combined score from the “yes, very much” and “yes, but little” options under knowledge of involvement of anaesthesia for the planned surgery, reason, type, advantages, problems, alternative forms of anaesthesia, sufficiency of time spent and information conveyed, as well as under allowance of expression, ease of understanding of language used and satisfaction; the combined proportion of consenters who chose the “yes, but very little” and “no, not at all” options ranged 16.88 –  78.44%.

Conclusion: Adequacy of information conveyed to consenters for obtaining informed consent was <80% in the depth of information conveyed, allowance of expression, ease of understanding of language and satisfaction.