Benefits and Barriers to Increasing Regional Anesthesia in Resource-Limited Settings
subject: Developing Countries, low-resource countries, Regional anesthesia, Anesthesia safety, ultrasound-guided nerve blocks
description: Lena Ebba Dohlman,1 Andrew Kwikiriza,2 Odinakachukwu Ehie3 1Department of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA; 2Department of Anaesthesia and Critical Care, Mbarara Regional Referral Hospital, Mbarara University of Science and Technology, Mbarara, Uganda; 3Department of Anesthesiology and Perioperative Services, University of California San Francisco, San Francisco, CA, USACorrespondence: Odinakachukwu EhieDepartment of Anesthesiology and Perioperative Services, University of California San Francisco, 1975 4th Street, Suite C2823, San Francisco, CA 94158-3217, USATel +1 415-476-4392Fax +1 415 476 4926Email odi.ehie@ucsf.eduAbstract: Safe and accessible surgical and anesthetic care is critically limited for over half of the world’s population, particularly in Sub-Saharan African and Southeast Asian countries. Increasing the use of regional anesthesia in these areas has potential benefits regarding access, safety, and cost-effectiveness. Perioperative anesthesia-related mortality is significantly higher in resource-limited countries and every effort should be made to encourage the use of anesthetic techniques in these countries that are safest under the present conditions. Studies from Sub-Saharan Africa, although limited in number, have shown a lower risk of death with regional compared to general anesthesia. Regional anesthesia has the further benefit of decreasing the risk of COVID-19 spread to healthcare providers by avoiding the aerosol-generating procedures that occur during general anesthesia. Neuraxial regional anesthesia is relatively easy to teach and perform and is considered the anesthetic of choice for surgeries below the umbilicus in resource-limited settings due to its safety, efficacy, and low cost. Although regional anesthesia has multiple potential advantages, education and training of anesthetic providers in low-and-middle-income countries (LMIC) are a significant barrier to growth. Anesth…
creator: Dohlman LE, Kwikiriza A, Ehie O
source: Biotemas
publisher: Universidade Federal de Santa Catarina
date: 2020
coverage: Anesthesiology