Anaesthesia-Related Child Mortality in a Niger Delta Tertiary Hospital: 5-Year Impact of Paediatric Anaesthesia Training

Abstract : Background: A rising under-five perioperative death occurring especially in sub-Saharan Africa, despite global decline in child mortality over the last decade, necessitates a review of the contribution from anaesthesia-related causes. Objective: To analyze the 5-year impact of Paediatric Anaesthesia Fellowship on anaesthesia-related child deaths in the University of Port Harcourt Teaching Hospital (UPTH). Method: A five-year survey of all anaesthetic interventions and outcomes in children aged 0 to 5 years, in UPTH, was undertaken. Data including general or loco-regional anaesthesia for elective/emergency surgeries, sedation-analgesia for diagnostic radiology, the indications, perioperative critical events/child deaths up to 24 hours following anaesthesia, and their causes, were obtained from the registers and records of the relevant units in the UPTH, after ethical approval. Results: Totally, 1596 anaesthetic interventions [987 (61.842%) electives; 609 (38.158%) emergencies] and outcomes were reviewed. General anaesthesia with endotracheal tube (GA + ETT) placement was the most frequent form of anaesthesia, administered to 1,075 (67.36%), and perioperative laryngospasm [49 (3.07%)] was the ranking critical event, followed by hypoxaemia, delayed recovery and difficult tracheal intubation respectively as the second, third and fourth, with the corresponding values of 34 (2.13%), 33 (2.07%) and 25 (1.57%); anaesthesia-related mortality was 1 (0.06%), occurring postoperatively from respiratory failure, following GA + ETT placement for elective abdominoplasty in a child with Prune-belly Syndrome. Conclusion: Within the five-year period in this survey, anaesthesia-related child mortality was 1 (0.06%), occurring postoperatively from respiratory failure.