457 posters, 2 videos, 2 audios, 8 topics, 45 sessions, 401 authors, 265 institutions

49th Annual Regional Anesthesiology and Acute Pain Medicine Meeting

March 21-23, 2024 | The Hilton Bayfront San Diego | San Diego, California

5564

ADVANCING MATERNAL PAIN MANAGEMENT AFTER CESAREAN SECTION IN A RURAL TANZANIAN HOSPITAL THROUGH HYBRID GLOBAL HEALTH EDUCATION

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Poster Presenter

Joseph Hodapp

Authors

Joseph Hodapp

Affiliations

Stanford University, Stanford University Department of Anesthesiology, Perioperative and Pain Medicine

Part of Topic

Safety/QA/QI Projects

Advancing maternal safety and pain management after Cesarean section in rural Tanzania hospital

Joseph Hodapp, MD*; Sehewa Mganga RN^; Gabriel Paul, MD^; Nkeiruka Umeh, MD*; Cynthia Khoo, MD, PhD*

Introduction

A woman from Africa has a 1 in 6 lifetime risk of dying during pregnancy and 99% of maternal deaths occur in low-income countries (1).
Obstetric anesthesia education is vital for low resource settings (2).
Spinal and regional anesthetics have a 30- to 40-fold lower mortality rate compared to general anesthetics yet are underutilized due to insufficient training (3).
Aim: to assess the translation of hybrid global health education to the development of regional and acute pain protocols and subsequent impact on maternal post-cesarean section pain.

Methods

Phase 1: Partnership

Remote 2-week workshops, twice per year 2021-2023
Regional anesthesia & acute pain and obstetric anesthesia

Phase 2: Assess

June 2023-January 2024
6-month data collection of pain scores after Cesarean section
FAME head nurse anesthetist visiting observership at Stanford

Phase 3: Implement

January 2024-Present
Stanford team traveled to Tanzania for supervision of Transversus Abdominis Plane (TAP) blocks
6-month data collection of pain scores after introduction of TAP blocks

Results:

Tanzanian nurse anesthetists adopted several acute pain practices after our bi-directional partnership

Involving patients in discussions about their care
Numerical pain rating scale
Multimodal analgesic strategies
Expanding access to regional anesthesia and long acting opiates

Post-operative pain after C-section

Pain is high initially, but improves quickly
Satisfaction with pain management is 99%
Adherence to multimodal strategy is high
Side effect profile suggests potential for improvement

Conclusion

Fostering longitudinal global relationships via a hybrid virtual and in-person bi-directional exchange has an potential to improve pain management and access to regional anesthetic care