RESEARCH ARTICLE


Practice of Regional Anesthesia and Its Associated Factors among Anesthesia Professionals Working in Teaching Referral Hospitals of Ethiopia; A Multi-center Study



Elias Habtu1, Mamo Nigatu2, Yemane Ayele3, Mebratu Tila1, Wondu R. Demissie4, *
1 Department of Anesthesia, College of Health Science, School of Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
2 Department of Biostatistics and Epidemiology, Institute of Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia
3 School of Anesthesia, Institute of Health, Faculty of Medical Science, Jimma University, Jimma, Ethiopia
4 Department of Biomedical Sciences, Institute of Health, Faculty of Medical Science, Jimma University, Jimma, Ethiopia


© 2021 Habtu et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Biomedical Sciences, Jimma University, Institute of Health, Faculty of Medical Science, Jimma, Ethiopia; P.O.Box 378; Tel: +251-471111457; Fax: +251471111450; E-mail: majore04@gmail.com; wondu.demissie@ju.edu.et


Abstract

Background:

Regional Anesthesia (RA) provides site-specific, complete pain relief, early mobilization, and rehabilitation; and it is preferred than general anesthesia due to associated risks in the later technique. It also ensures prolonged analgesia while reducing the need for systemic drugs with their side effects. Despite these advantages, the techniques have not been embraced as alternatives to general anesthesia in Ethiopia.

Objective:

The study aimed to assess the magnitude of regional anesthesia practice and its associated factors among Anesthesia Care Providers (ACPs) working in Ethiopian teaching referral hospitals, 2019.

Materials and Methods:

Multi-center-based crossectional study was conducted among all ACPs working in three institutions (Jimma Medical Center, Black Lion hospital and Wolaita Sodo teaching referral hospital) which were randomly selected among six government teaching referral hospitals running postgraduate anesthesia programs; from August 1-September 1, 2019. The practice of RA was considered significant if the participants performed >5 types of RA, assuming as minimum representation (30%) of all types of RA. Data were entered into Epidata manager version 4.3 and exported to SPSS version 22 for further analysis. Logistic regression was applied to determine predictors of RA practice. Adjusted odds ratio and 95% CI interval were used to measure the association and P-value <0.05 was declared as statistically significant.

Results:

Out of 143 participants, a total of 130 anesthesia professionals participated in the study, making the response rate of 90% . The mean age was 30.77±7.049 years that ranges from 22-56 years. Majority of the respondents were males, 88(67.7%). About 59.2% of ACPs practiced RA. The most performed types of RA were spinal anesthesia (98.5%), caudal anesthesia (72.3%) and axillary block (69.2%), while sub gluteal sciatic block and IV RA were the least practiced types of RA (8.5% each). Finally, two variables (years of experience (1-5 years) and academic qualification (above MSc)) were identified as the independent predictors of RA practice among ACPs with AOR of 6(1.7-21.6), p-v =0.005 and 10.4(1.9-56.9), p-v =0.007 respectively.

Conclusion:

In a nutshell, the practice of RA in teaching government hospitals of Ethiopia was relatively low despite some RA types like SA were almost practiced well. Thus, ACPs were expected to practice all types of RA than routinely abusing GA for patient safety and welfare in all dimensions.

Keywords: Regional anesthesia practice, Teaching institutions, Epidural Anesthesia, Anesthesia care providers, Associated factors, Caudal anesthesia.