title: Pediatric anesthesia in developing countries: experience in the two main university hospitals of Benin in West Africa.
abstract: OBJECTIVE
  To describe the practice of pediatric anesthesia in the main University Hospitals in Benin.
  
  
  METHODS
  We conduct a retrospective study involving 512 children at the 'Centre National Hospitalier et Universitaire' and the 'Hôpital de la Mère et de l'Enfant Lagune' in Cotonou. All children less than 15 years of age undergoing surgery from January to December 2007 were included. Patient demographics, anesthetic technique, perioperative monitoring and complications were analyzed.
  
  
  RESULTS
  General anesthesia was used in 94% of children. Regional anesthesia was used in 1.7% of children at CNHU and 17% of children at Hôpital de la Mère et de l'Enfant Lagune. Inhalational induction was the commonest technique used. Halothane was the only inhalational agent available for induction. Seventy-two percent of children having general anesthesia were intubated. Muscle relaxation was used in 48% of cases, only with pancuronium. The available perioperative monitoring equipment was not used regularly. All children having general anesthesia breathed spontaneously with manual assistance. There were eight cardiac arrests recorded, giving an incidence of 156 cardiac arrests per 10,000 anesthetics. Hypoxia was the commonest cause of cardiac arrest. The mortality associated with cardiac arrest was very high (62%). There were three prognostic factors that predicted a poor outcome: age <1 year, emergency surgery and an ASA score of three or more.
  
  
  CONCLUSIONS
  Pediatric anesthesia in the two University Hospitals is far from satisfactory. Morbidity and mortality are unacceptably high. Suggestions are made to improve the safety of children undergoing anesthesia.
authors.affiliation: Faculté des Sciences de la Santé, B.P. 188 Cotonou, Service d'Anesthésie-Réanimation, Hôpital de la Mère et de l'Enfant Lagune (Cotonou). ezoumenou@yahoo.fr
authors.forename: Eugène
authors.initials: E
authors.lastname: Zoumenou
authors.forename: Séraphin
authors.initials: S
authors.lastname: Gbenou
authors.forename: Pamphile
authors.initials: P
authors.lastname: Assouto
authors.forename: Aboudoul-Fataou
authors.initials: AF
authors.lastname: Ouro Bang'na Maman
authors.forename: Thomas
authors.initials: T
authors.lastname: Lokossou
authors.forename: Gervais
authors.initials: G
authors.lastname: Hounnou
authors.forename: Abdou Rhaman
authors.initials: AR
authors.lastname: Aguemon
authors.forename: Martin
authors.initials: M
authors.lastname: Chobli
mesh_terms: D000293:Adolescent; D000758:Anesthesia / Q000009:adverse effects / Q000401:mortality; D000765:Anesthesia, Conduction / Q000706:statistics & numerical data; D000768:Anesthesia, General / Q000706:statistics & numerical data; D000776:Anesthesiology / Q000706:statistics & numerical data / Q000639:trends*; D001541:Benin; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006323:Heart Arrest / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016343:Monitoring, Intraoperative; D010372:Pediatrics / Q000706:statistics & numerical data / Q000639:trends*; D011997:Recovery Room; D012189:Retrospective Studies; D012737:Sex Factors; D000078329:Workforce