Audit of epidural anaesthesia services at a district hospital in Nigeria

Abstract

Background: Epidural anaesthesia and analgesia is considered the 'gold standard' analgesic technique for major surgery. However, its practice is limited in most hospitals in Nigeria. The objective of this review was to determine the rate of administration of epidural anaesthesia and to review the challenges affecting its routine use in a District Hospital. 
Methods: This was a retrospective study of all patients who received anaesthesia in the hospital between 2010 and 2011. Data extracted from the hospital record included the age and sex of the patients, type of surgery, types of anaesthesia used, outcomes of anaesthesia and the grade of anaesthetists involved.
Results: A total of 2,828 anaesthetic procedures were carried out during the study period with 1,288 and 1,540 administered in 2010 and 2011 respectively. Three (0.2%) of the anaesthetic procedures were epidural in 2010 and 18 (1.2%) in 2011, giving a 500% increase in rate of its administration. Epidural anaesthesia constituted 0.74% (21/2,828) of all anaesthetic procedures. Of these, 16 (76%) were performed on females and 5 (24%) were males. Five Nurse Anaesthetists and one Consultant Anaesthetist provided anaesthesia services.There was no record of morbidity or mortality related to epidural anaesthesia.
Conclusion: Epidural anaesthesia is safe but its utilization is very low at this clinical setting. More physician anaesthetists need to be trained in order to increase the practice of epidural anaesthesia.

Keywords: Anaesthesia, Epidural, Maitama Hospital, Physician anaesthetist