Reversal of Neuromuscular Blockade: A Discrete Event Simulation Model of Clinical and Operating Room Efficiency Outcomes of Sugammadex Versus Neostigmine In Canada

Abstract

and CHUK, Burundi. Using a questionnaire based on the World Federation of the Societies of Anaesthesiologists (WFSA) guidelines for safe anaesthesia, we assessed demographic, administrative, peri-operative variables by interviewing anaesthetists in these hospitals, key informants from the Ministry of Health and National Anaesthesia Society of each country. Results: Using the WFSA checklist as a guide, only four percent of respondents were able to provide safe obstetric anaesthesia, and only seven percent reported adequate anaesthesia staffing. There were only 30 anaesthesiologists in Uganda, 168 in Kenya, 22 in Tanzania, 15 in Rwanda, and 2 in Burundi. Hospitals were barely equipped with monitors that sometimes were not functional. The paucity of local protocols, the failed referral system and lack of intensive care unit services was also reported to contribute significantly to poor maternal outcomes. ConClusions: We identified significant shortages of both personnel and equipment needed to provide safe anaesthetic care for obstetric surgical cases across East Africa. There is need to develop policies and strengthen the health systems in order to improve surgical outcomes in developing countries.