Anaesthesia practice by nurse anaesthetists in French speaking subsaharian Africa.

Objective: To evaluate the practice of anaesthesia in French-speaking subsaharian countries. Type of study: Prospective survey Persons: Two hundred seventeen nurse anaesthetists, from 11 different countries. Methods: Anonymous questionnaire. Results: One third of nurses were practising anaesthesia since less than five years and 1/3 since more than 10. Only 39 (18%) were working in the country side. Thirty seven (17%) had been trained outside subsaharian Africa tin Cuba 6%, France 5%, Morocco 5% and Germany 1% respectively). Two hundred thirteen (98%) were performing general anaesthesia and 169 (78%) regional anaesthesia. Hundred sixty eight (97%) used spinal anaesthesia, 57 (33%) epidural, 31 (18%) intravenous regional anaesthesia, 24 (14%) axillary block, 17 (10%) caudal block and 10 (6%) peripheral block respectively. For regional techniques, disposable devices were available in 50% of cases. For general anaesthesia, thiopental was administered by 193 (89%) and ketamine by 156 (72%) nurse anaesthetists respectively. In 50% of cases, these drugs were used alone. An ECG was available in 40%, a pulse oximeter in 14% and a capnographe in less than 2% of cases. A ventilator was present in 66% of the places, but used only in 30% of them because of the lack of maintenance and training. Conclusions: In this study, 50% of nurse anaesthetists were working alone. However, this rate is probably underestimated I as the questionnaire did not consider anaesthesia practice in the country side. (C) 1999 Elsevier, Paris.