Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

Afolabi Muyiwa Owojuyigbe; Edward O Komolafe; Anthony T Adenekan; Muyiwa A Dada; Chiazor U Onyia; Ibironke O Ogunbameru; Oluwafemi F Owagbemi; Ademola O Talabi; Fola A Faponle

doi:10.4103/0189-6725.182561

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ORIGINAL ARTICLE

Year : 2016 | Volume : 13 | Issue : 2 | Page : 76-81

Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice

Afolabi Muyiwa Owojuyigbe¹, Edward O Komolafe², Anthony T Adenekan¹, Muyiwa A Dada³, Chiazor U Onyia³, Ibironke O Ogunbameru³, Oluwafemi F Owagbemi³, Ademola O Talabi⁴, Fola A Faponle¹
¹ Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria
² 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
³ Department of Surgery, Neurosurgery Unit, Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife, Osun State, Nigeria
⁴ Department of Surgery, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria

Correspondence Address:
Afolabi Muyiwa Owojuyigbe
Department of Anaesthesia and Intensive Care, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife 220282, Osun State
Nigeria

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0189-6725.182561

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. Patients and 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. Conclusion: Paediatric day-case neurosurgery is feasible in our environment. With careful patient selection and adequate pre-operative preparation, good outcome can be achieved.

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