全球儿科麻醉-英语西非视角
Ibironke Desalu1, Pokua Sarpong2, Maryrose O Osazuwa3
1University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Paediatric anaesthesia
|February 7, 2024
概括
英语西非地区的儿科麻醉在受过培训的员工和资源方面面临着严重的短缺. 解决这些问题需要增加政府的卫生预算,国际合作,以及为儿科麻醉提供者提供专门的培训计划.
科学领域:
- 麻醉学 麻醉学
- 儿科护理 儿科护理
- 全球健康 全球健康
背景情况:
- 英语西非拥有年轻人口 (超过40%的年龄在14岁以下),对儿科麻醉的需求日益增加.
- 分析了五个国家 (喀麦隆,尼日利亚,加纳,利比里亚,冈比亚) 的儿科麻醉环境.
研究的目的:
- 提供来自英语西非的儿科麻醉视角.
- 突出该地区儿科麻醉服务面临的挑战和潜在解决方案.
主要方法:
- 这项研究回顾了五个英语西非国家的儿科麻醉服务的现状.
- 它检查了劳动力密度,培训机会,服务交付模式和现有挑战.
主要成果:
- 劳动力密度极低,训练有素的儿科麻醉师很少.
- 各种医院类型提供服务,但面临重大挑战:缺乏人员,病人迟到出院,财务限制,设备/药物不足.
- 限定的儿科专用手术室和重症监护设施加剧了这个问题.
结论:
- 尼日利亚和加纳正在出现由非政府组织支持的分专业培训计划.
- 通过国家卫生计划宣传和政府对麻醉/手术服务的优先考虑是至关重要的.
- 在培训劳动力和建立儿童医院方面的国际合作对于改善儿童麻醉护理至关重要.
相关概念视频
General Anesthesia: Overview
219
Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
219
Local Anesthetics: Clinical Application as Epidural Anesthesia
432
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
432
Parenteral Anesthetics: Overview
127
Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
127
Local Anesthetics: Clinical Application as Spinal Anesthesia
632
Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...
632
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
417
Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
One of the advantages of...
417
Inhalational Anesthetics: Overview
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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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