Teaching neuraxial anesthesia techniques for obstetric care in a Ghanaian referral hospital: achievements and obstacles.


Anesthesia providers in low-income countries may infrequently provide regional anesthesia techniques for obstetrics due to insufficient training and supplies, limited manpower, and a lack of perceived need. In 2007, Kybele, Inc. began a 5-year collaboration in Ghana to improve obstetric anesthesia services. A program was designed to teach spinal anesthesia for cesarean delivery and spinal labor analgesia at Ridge Regional Hospital, Accra, the second largest obstetric unit in Ghana. The use of spinal anesthesia for cesarean delivery increased significantly from 6% in 2006 to 89% in 2009. By 2012, >90% of cesarean deliveries were conducted with spinal anesthesia, despite a doubling of the number performed. A trial of spinal labor analgesia was assessed in a small cohort of parturients with minimal complications; however, protocol deviations were observed. Although subsequent efforts to provide spinal analgesia in the labor ward were hampered by anesthesia provider shortages, spinal anesthesia for cesarean delivery proved to be practical and sustainable.





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Publication Info

Olufolabi, Adeyemi J, Evans Atito-Narh, Millicent Eshun, Vernon H Ross, Holly A Muir and Medge D Owen (2015). Teaching neuraxial anesthesia techniques for obstetric care in a Ghanaian referral hospital: achievements and obstacles. Anesth Analg, 120(6). pp. 1317–1322. 10.1213/ANE.0000000000000464 Retrieved from https://hdl.handle.net/10161/10333.

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Adeyemi John Olufolabi

Professor of Anesthesiology

My interests include obstetric and gynecological anesthesia research. This includes the use of opioids in obstetric population.  I also have an interest in the management of the difficult airway in general anesthesia and in the Obstetric population. More recently, I have been engaged in global health and the role of anesthesia in resolving the disparity gap.  I have a particular interest in anesthesia in sub-sahara Africa and have been involved in capacity building, research and educational endeavors in that sphere.

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