Pattern of anaesthesia techniques for herniotomy at a southwestern tertiary health institution: a 5-year review

Abstract

Background: Anaesthesia for herniotomy may be challenging because the margin of error in managing such a young patient can be extremely small since the body reserves are limited and the organ systems may not be fully developed. Also, the psychological, physiological and pharmacological responses to anaesthesia are quite different from adult. Safe and effective care of children under anaesthesia is therefore crucial. This study aims to audit the pattern of anaesthetisia techniques used and their associated complications during herniotomy procedure in our health facility. Material and methods: This is a retrospective review of patients’ files, theatre records and anaesthetic-record charts of herniotomy cases performed in a tertiary health Institution from January 2011 to December 2015. Relevant clinical information were entered into proforma designed for the study. Data was analysed with descriptive statistics using the Statistical Package for Social Sciences (SPSS) version 20 Chicago IL (U.S.A). Inferential statistics of Chi-Square, Mann-Whitney and Kruskal-Wallis Test were alsoperformed. Results: One hundred and fortyfour in-patient children who belonged to American Society of Anesthesiologists Physical Health Status (ASA) grade I and II had herniotomies during the study period. The mean age is 4.21±3.72years (range, 6months – 16years) with male to female ratio of 47:1 (i.e 141 to 3). General anaesthesia (135, 94%) of various techniques was the most common technique while regional anaesthesia was only employed in nine (6%) children. The regional anaesthesia techniques were caudal block 1 (0.7%) and subarachnoid block 8 (5.5%) and were sedated to allow for cooperation in some of the cases. One hundred and twenty-four (86%) children presented as simple, elective cases while twenty (14%) children as complicated or emergency cases. Conclusion: This study showed that herniotomy can be safely performed under various options of anaesthesia techniques depending on the expertise of the anaesthetists involved. The simple, electives inguinal hernia and hydroceles could have been performed as day cases.