Feasibility and Safety of Spinal Anaesthesia for Paediatric Herniotomy in a Resource-Limited Outreach Setting in Abia State, Southeast Nigeria.

BACKGROUND

Subarachnoid block (spinal anaesthesia) is a safe, cost-effective option for paediatric surgery, especially in resource-limited settings. In rural Nigeria, where surgical outreach programs provide vital care, this technique offers rapid onset, reliable analgesia, minimal airway manipulation, and fewer postoperative complications.

METHODOLOGY: This prospective observational study was conducted over six months (September 2025-March 2026) during surgical outreach programs in Ebem Ohaofia, Abia State, and at Madonna Catholic Hospital and Isiala Ngwa North Hospital. Sixty-one consecutive paediatrics patients aged 2-8 years undergoing herniotomy under subarachnoid block were enrolled. Relevant perioperative data, including block characteristics, intraoperative hemodynamic parameters, and complications, were collected and analysed.

RESULTS

A total of 61 children aged 2-8 years underwent herniotomy under subarachnoid block (SAB). There was a male predominance (50 males, 11 females; ratio 4.5:1). No cases of failed block or conversion to general anaesthesia were recorded. Intraoperatively, no patient developed bradycardia, while hypotension occurred in one patient (1.6%), who was aged 8 years. Perioperative shivering was observed in five patients (8.2%) and was treated with pentazocine (0.25 mg/kg). The most common postoperative complaint was pain, reported in 16.4% (10) of patients.

CONCLUSIONS

Subarachnoid block appears to be a practical anaesthetic technique for paediatric patients in surgical outreach programs in rural Abia State. Its advantages, including rapid onset, minimal equipment requirements, and favourable recovery profile, make it particularly suitable for resource-limited settings.