Mark J Harris1, Thaim B Kamara2, Eva Hanciles3, Cynthia Newberry1, Scott R Junkins1, Nathan L Pace1. 1. Department of Anesthesiology (Rm 3C444), University of Utah Medical Center Salt Lake City, USA. 2. Department of Surgery, Connaught Hospital Freetown, Sierra Leone. 3. Department of Anæsthesiology Connaught Hospital Freetown, Sierra Leone.
Abstract
OBJECTIVES: To determine the unmet anaesthesia need in a low resource region. INTRODUCTION: Surgery and anæsthesia services in low- and middle-income countries (LMICs) are under-equipped, under-staffed, and unable to meet current surgical need. There is little objective measure as to the true extent and nature of unmet need. Without such an understanding it is impossible to formulate solutions. Therefore, we re-examined Surgeons OverSeas (SOSAS) unmet surgical need data to extrapolate unmet anaesthesia need. METHODS: For the untreated surgical conditions identified by SOSAS, we assigned anaesthetic technique required to carry out the procedure. The chosen anaesthetic was based on common practice in the region. Procedures were categorized into minimal anaesthesia, spinal anæsthesia, regional anaesthesia, ketamine/monitored anaesthesia care (MAC), and general endotracheal anæsthesia (GETA). DISCUSSIONS: Ninety-two per cent (687 of 745) of untreated surgical conditions in Sierra Leone would require some form of anaesthesia. Seventeen per cent (125 of 745) would require MAC, 22% (167 of 745) would require spinal anaesthesia, and 53% (395 of 745) would require GETA. CONCLUSION: Analyses such as this can provide guidance as to the rational and efficient production and distribution of personnel, drugs and equipment.
OBJECTIVES: To determine the unmet anaesthesia need in a low resource region. INTRODUCTION: Surgery and anæsthesia services in low- and middle-income countries (LMICs) are under-equipped, under-staffed, and unable to meet current surgical need. There is little objective measure as to the true extent and nature of unmet need. Without such an understanding it is impossible to formulate solutions. Therefore, we re-examined Surgeons OverSeas (SOSAS) unmet surgical need data to extrapolate unmet anaesthesia need. METHODS: For the untreated surgical conditions identified by SOSAS, we assigned anaesthetic technique required to carry out the procedure. The chosen anaesthetic was based on common practice in the region. Procedures were categorized into minimal anaesthesia, spinal anæsthesia, regional anaesthesia, ketamine/monitored anaesthesia care (MAC), and general endotracheal anæsthesia (GETA). DISCUSSIONS: Ninety-two per cent (687 of 745) of untreated surgical conditions in Sierra Leone would require some form of anaesthesia. Seventeen per cent (125 of 745) would require MAC, 22% (167 of 745) would require spinal anaesthesia, and 53% (395 of 745) would require GETA. CONCLUSION: Analyses such as this can provide guidance as to the rational and efficient production and distribution of personnel, drugs and equipment.
Authors: Stefan Jochberger; Feruza Ismailova; Wolfgang Lederer; Viktoria D Mayr; Günter Luckner; Volker Wenzel; Hanno Ulmer; Walter R Hasibeder; Martin W Dünser Journal: Anesth Analg Date: 2008-03 Impact factor: 5.108
Authors: Reinou S Groen; Mohamed Samai; Kerry-Ann Stewart; Laura D Cassidy; Thaim B Kamara; Sahr E Yambasu; T Peter Kingham; Adam L Kushner Journal: Lancet Date: 2012-08-14 Impact factor: 79.321
Authors: Drake G Lebrun; Iracema Saavedra-Pozo; Fernando Agreda-Flores; Mackenzie L Burdic; Michelle R Notrica; K A Kelly McQueen Journal: World J Surg Date: 2012-11 Impact factor: 3.352