title: Anesthesia for Ambulatory Pediatric Surgery in Sub-Saharan Africa: A Pilot Study in Burkina Faso.
abstract: Long surgical wait times and limited hospital capacity are common obstacles to surgical care in many countries in Sub-Saharan Africa (SSA). Introducing ambulatory surgery might contribute to a solution to these problems. The purpose of this study was to evaluate the safety and feasibility of introducing ambulatory surgery into a pediatric hospital in SSA.
  
  
  
  This is a cross-sectional descriptive study that took place over 6 months. It includes all patients assigned to undergo ambulatory surgery in the Pediatric University Hospital in Ouagadougou, Burkina Faso. Eligibility criteria for the ambulatory surgery program included >1 year of age, American Society of Anesthesiologists (ASA) 1 status, surgery with a low risk of bleeding, lasting <90 minutes, and with an expectation of mild to moderate postoperative pain. The family had to live within 1 hour of the hospital and be available by telephone.
  
  
  
  During the study period, a total of 1250 patients underwent surgery, of whom 515 were elective cases; 115 of these met the criteria for ambulatory surgery; 103 patients, with an average age of 59.74 ± 41.57 months, actually underwent surgery. The principal indications for surgery were inguinal (62) and umbilical (47) hernias. All patients had general anesthesia with halothane. Sixty-five percent also received regional or local anesthesia consisting of caudal block in 79.23% or nerve block in 20.77%. The average duration of surgery was 33 ± 17.47 minutes. No intraoperative complications were noted. All the patients received acetaminophen and a nonsteroidal anti-inflammatory drug in the recovery room. Twelve (11.7%) patients had complications in recovery, principally nausea and vomiting. Eight (7.8%) patients were admitted to the hospital.
  
  
  
  No serious complications were associated with ambulatory surgery. Its introduction could possibly be a solution to improving pediatric surgical access in low-income countries.
authors.affiliation: From the *Pediatric University Hospital Charles De Gaulle, Ouagadougou, Burkina Faso; †University Hospital Yalagdo Ouedraogo, Ouagadougou, Burkina Faso; and ‡University Hospital Souro Sanou, Bobo Dioulasso, Burkina Faso.
authors.forename: Yvette B
authors.initials: YB
authors.lastname: Kabré
authors.forename: Idriss S S
authors.initials: IS
authors.lastname: Traoré
authors.forename: Flavien A R
authors.initials: FA
authors.lastname: Kaboré
authors.forename: Bertille
authors.initials: B
authors.lastname: Ki
authors.forename: Alain I
authors.initials: AI
authors.lastname: Traoré
authors.forename: Isso
authors.initials: I
authors.lastname: Ouédraogo
authors.forename: Emile
authors.initials: E
authors.lastname: Bandré
authors.forename: Albert
authors.initials: A
authors.lastname: Wandaogo
authors.forename: Nazinigouba
authors.initials: N
authors.lastname: Ouédraogo
mesh_terms: D000293:Adolescent; D017954:Africa South of the Sahara / Q000453:epidemiology; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000758:Anesthesia; D000768:Anesthesia, General; D000772:Anesthesia, Local; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D006554:Hernia, Umbilical / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009407:Nerve Block; D010372:Pediatrics / Q000379:methods*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology