Anaesthesia for neonatal surgical emergencies in a semi-urban hospital, Nigeria

Abstract

Objective: To establish the techniques of anaesthesia for neonatal surgical emergencies in a semi-urban hospital in Nigeria, assess their adequacy and make recommendations to improve our practice.

Design: Retrospective study.

Setting: Obafemi Awolowo University Teaching Hospital, Ile-lfe, Nigeria, from January 1990 to December 2000.

Subjects: One hundred neonates aged one to twenty eighty days.

Results: One hundred neonatal surgical emergencies were operated but only 76 case notes were available for review. Three hundred and fifty eight elective neonatal surgeries were done during the same period. The ASA classification were: ASA IE=10, 2E=25, 3E=28, 4E =12 and 5E=1. The mean weight was 2.66+/ 0.52 kg. Over 95% of the cases were done under general anaesthesia. Anorectal malformations and intestinal obstruction were the most common indications for surgery (64.5%). Nurse anaesthetists gave over 50% of the anaesthetics. Peri-operative adverse events such as tachycardia, respiratory distress, aspiration and hypothermia were recorded in 11.8% of the cases. Mortality was 39.2%.

Conclusion: General anaesthesia is still the main technique of anaesthesia and mortality following surgery is still high. Efforts should be made to train appropriate personnel to provide improved care and thereby reduce morbidity and mortality.