title: Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice.
abstract: BACKGROUND
  It has been generally observed that children achieve better convalescence in the home environment especially if discharged same day after surgery. This is probably due to the fact that children generally tend to feel more at ease in the home environment than in the hospital setting. Only few tertiary health institutions provide routine day-case surgery for paediatric neurosurgical patients in our sub-region.
  
  
  OBJECTIVE
  To review the pattern and practice of paediatric neurosurgical day-cases at our hospital.
  
  
  METHODS
  A prospective study of all paediatric day-case neurosurgeries carried out between June 2011 and June 2014.
  
  
  RESULTS
  A total of 53 patients (34 males and 19 females) with age ranging from 2 days to 14 years were seen. Majority of the patients (77.4%) presented with congenital lesions, and the most common procedure carried out was spina bifida repair (32%) followed by ventriculoperitoneal shunt insertion (26.4%) for hydrocephalus. Sixty-eight percentage belonged to the American Society of Anesthesiologists physical status class 2, whereas the rest (32%) belonged to class 1. General anaesthesia was employed in 83% of cases. Parenteral paracetamol was used for intra-operative analgesia for most of the patients. Two patients had post-operative nausea and vomiting and were successfully managed. There was no case of emergency re-operation, unplanned admission, cancellation or mortality.
  
  
  CONCLUSIONS
  Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved.
authors.affiliation: Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Afolabi Muyiwa
authors.initials: AM
authors.lastname: Owojuyigbe
authors.affiliation: Department of Surgery, Faculty of Clinical Sciences, Obafemi Awolowo University; Department of Surgery, Neurosurgery Unit, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Edward O
authors.initials: EO
authors.lastname: Komolafe
authors.affiliation: Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Adenekan
authors.affiliation: Department of Surgery, Neurosurgery Unit, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Muyiwa A
authors.initials: MA
authors.lastname: Dada
authors.affiliation: Department of Surgery, Neurosurgery Unit, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Chiazor U
authors.initials: CU
authors.lastname: Onyia
authors.affiliation: Department of Surgery, Neurosurgery Unit, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Ibironke O
authors.initials: IO
authors.lastname: Ogunbameru
authors.affiliation: Department of Surgery, Neurosurgery Unit, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria.
authors.forename: Oluwafemi F
authors.initials: OF
authors.lastname: Owagbemi
authors.affiliation: Department of Surgery, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Ademola O
authors.initials: AO
authors.lastname: Talabi
authors.affiliation: Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
authors.forename: Fola A
authors.initials: FA
authors.lastname: Faponle
mesh_terms: D000293:Adolescent; D000556:Ambulatory Surgical Procedures; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D019635:Neurosurgical Procedures; D009549:Nigeria; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies