Anaesthesia for Surgical Outreach in a Rural Nigerian Hospital

Background: Surgical outreach to rural areas is aimed at improving access to surgical treatment to a deprived community. The study reports the experience of a team consisting of specialist surgical and anaesthetic manpower during a five day surgical outreach at Ogoja General Hospital, Nigeria in 2010. This was on the occasion of the 50th anniversary of the West African College of Surgeons. Ogoja General Hospital though is a hospital that offers 24 hour surgical services; lacks basic facilities for administration of regional and general anaesthesia for all categories of patients as well as patient monitors.Patients and Method: Patients with surgical pathologies that involved minimum blood loss, postoperative pain and care were selected for surgery having been previously screened by resident medical officers.Results: A total of 119 patients had 136 surgical procedures representing 18.4% of the patients screened. Paediatric patients consisted 46% of the cases done. Majority of the patients were males (73%) and hernia (67%) was the most frequent pathology. The main anaesthetic technique was Spinal Anaesthesia (68.8%) in adults and ketamine based Total Intravenous Anaesthesia (TIVA) (90.9%) in children. There was no mortality and all patients were discharged within 24 hours.Conclusion: Rural dwellers have substantial burden of surgical pathologies that are amenable to surgery but lack access to surgery and safe anaesthesia. Careful selection of patients, specialist manpower and collaborations with the resident healthcare personnel improves outcome. Improvement in anaesthetic facilities and a subsidised health care scheme for the rural dwellers would improve access to safe anaesthesia and surgery