Tuesday, November 4, 2014

The second general anesthetic at Kibuye

Jason informed me last night that he had scheduled another case for today that would need general endotracheal anesthesia.  It was a 4 month old in need of a thoractomy with a giant congenital cyst obliterating her left lung.  For those of you reading this who do not work in the medical field, I will tell you that this is a case I would NEVER do in the US.  This is a case that would be referred to a Childrens hospital and performed by a pediatric thoracic surgeon with a pediatric anesthesiologist.  But, we are in Burundi, so we just do it ourselves.  

I am not going to lie to you, sphincter tone was high this morning.  After 2 hours of searching for an IV, the surgeon finally did a saphenous cut down, and off we went.  No arterial line, no central line, and just a 3.5 endotracheal tube that we shoved down the right mainstem bronchus for one lung ventilation.  Thankfully, the surgery went great, the kids woke up needing a little oxygen, but is now off oxygen and back in his bed with mom.  

And I am guessing that I will sleep better tonight than I did last night.


  1. Oh my heart for this baby, this operating room , this hospital...

  2. Good for you, Greg! Now you can do anything. But oh I was hoping you were going to say that there was a unexpired pediatric epidural kit and infusion pump there that was just the ticket for her recovery.

  3. Greg, when you say it was the second general case, does that mean that the rest of the cases have been done with local only? Or do you just not have much to do.....

  4. Hey JS! To answer your question, they have historically done as many surgeries as possible under spinal, and everything else under large doses of ketamine with a nasal cannula. They do laparotomies, C-sections, VP shunts, all under ketamine. So, when I said general anesthetic, what I should have said was general endotracheal anesthetic. Volume has definitely been increasing lately. We did around 240 cases last month. Thanks for reading the blog!