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Continental J. Medical Research 5 (1): 6 - 13, 2011 ISSN: 2141 – 4211
© Wilolud Journals, 2011 http://www.wiloludjournal.com
` Printed in Nigeria
MOBILE ANAESTHETIC PRACTICE –A NIGERIAN (10 YEARS) EXPERIENCE IN NIGER-DELTA
Abiodun Oyinpreye Jasper
Department of Anaesthesia, College of Health Sciences, Delta State UniversityAbraka Delta State, Nigeria
E- mail: aojasper@yahoo.com
ABSTRACT
The surgical needs of our environment have necessitated an increased demand for quality/improved
anaesthetic care; where local anaesthetic techniques would not suffice. Also increased awareness
amongst the populace has brought about this need. The need to improve the indices of maternal and
child morbidity and mortality which in international circles are presently yardsticks of measuring
development among developing nations has acted as the catalyst for ensuring safety amongst these very
vulnerable class of persons. With these factors in view especially with the availability of scarce
anaesthetic manpower and resources, government and private individual and even NGOs are asking for
improved anaesthetic services. My experience of mobile anaesthetic service provision over the past ten
years as an anaesthetist is my little way of bringing health care to the doorstep of the people in south-
south Nigeria. The procedures undertaken were mainly obstetric, gynecological, general surgical, minor
neurosurgical, urology and minor thoracic surgeries. The techniques adopted were regional and general
anaesthesia using a portable Boyle’s machine and accessories. Recommendations derived from this
experience are as follows 1)hospitals work within the limitation of manpower resources .2)Availability
of anaesthetic register and contact maintained especially in emergencies .3)Referral systems be made
use of .4)With the availability of mobile complete anaesthetic unit purchase of anaesthetic machines
may be unnecessary in small hospitals as they often go bad from disuse.5)More health workers need
training in basic life support, advanced cardiac life support , advanced trauma life support and acute life
threatening events recognition and treatment (ALERT) courses. These should be incorporated into
medical curriculum.
KEYWORDS: Mobile Anaesthesia, Safety, Manpower limitations, breaking barriers, Training.
INTRODUCTION
Surgical intervention may become necessary for patients in rural, suburban and urban hospitals where the
doctors are skilled and trained to do so. To facilitate this, some form of anaesthesia may be necessary requiring
the presence of an anaesthetist. The paucity of such anaesthetic services was the motivating factor in the
provision of mobile anaesthetic service-taking anaesthesia to the people: exploring the possibility of improving
surgical safety profile. My short experience spans ten years of taking anaesthesia where it is needed and when it
is needed. In the short period of time, procedures were undertaken in a wide range of surgical specialties which
in most cases needed special anaesthetic care mostly in unconventional and challenging circumstances in private
hospitals and government institutions. The availability of such mobile services removes the severe restrictions
imposed on the surgeon by the use of agents like ketamine which is commonly used for minor surgeries;
especially in the rural and sub-urban areas. In essence we provided anaesthesia without barriers.
DISCUSSION
In view of the shortage of anaesthetic manpower, mobile anaesthetic practice becomes a pattern of practice
which the qualified anaesthetist adopts. This pattern of practice is further enhanced by the seeming low