Pediatric anesthesia in developing countries: experience in the two main university hospitals of Benin in West Africa.
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.
Zoumenou
Eugène
E
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
Gbenou
Séraphin
S
Assouto
Pamphile
P
Ouro Bang'na Maman
Aboudoul-Fataou
AF
Lokossou
Thomas
T
Hounnou
Gervais
G
Aguemon
Abdou Rhaman
AR
Chobli
Martin
M
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