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Paediatric day-case neurosurgery in a resource challenged setting: Pattern and practice
Afolabi Muyiwa Owojuyigbe1, Edward O Komolafe2, Anthony T Adenekan1
1Department of Anaesthesia and Intensive Care, Obafemi Awolowo University, Ile-Ife, Osun State, Nigeria.
Insights
Pediatric day-case neurosurgery is safe and effective in our region. Careful patient selection and preparation lead to successful outcomes, with no emergency re-operations or mortality observed.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Day-Case Surgery
Background:
- Children recover better at home post-surgery.
- Hospitals can be stressful for pediatric patients.
- Limited day-case neurosurgery exists in our sub-region.
Purpose of the Study:
- To review pediatric neurosurgical day-case patterns.
- To evaluate the practice of day-case neurosurgery in our hospital.
Main Methods:
- Prospective study conducted from June 2011 to June 2014.
- Inclusion of all pediatric day-case neurosurgeries.
Main Results:
- 53 patients (2 days-14 years) underwent surgery.
- Congenital lesions (77.4%) were most common, including spina bifida repair (32%) and ventriculoperitoneal shunt insertion (26.4%).
- No emergency re-operations, unplanned admissions, cancellations, or mortality occurred; 2 patients experienced manageable post-operative nausea and vomiting.
Conclusions:
- Pediatric day-case neurosurgery is feasible locally.
- Careful patient selection and pre-operative preparation ensure good outcomes.
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.
