Surgery of COVID-19-infected patients in Africa: A scoping review

Objective: The aim of this scoping review was to highlight the nature and scope of research andpublications about surgery in COVID-19-infected patients in Africa in order to inform guidelinesapplicable in Africa. Methods: We considered peerreviewed and gray literature from PubMed, Google Scholar, and Word Health Organization COVID-19 online databases published from February 1, 2020, to February 28, 2021, about surgery for/in COVID-19-infected patients. The review is reported using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews. Results: Of 530 studies screened, only 11 (2.08%) were foundeligible, including 4 cohort studies, 3 cross-sectional studies, 2 letters to the editor, 1 case series, and 1 review. The key emphasis areas by the eligible studies were vaccination, testing prior to surgery, clinical guidelines to reduce complications related to COVID-19 among infected patients, and protection of the surgical team. Conclusion: There is a dearth of studies on surgery in COVID-19-infected patients in Africa. There is an urgent need for more reports and publications from the African experiences so as to inform contextualized guidelines for surgical care in low-resource settings during the COVID-19 pandemic

Pain assessment following open hemorrhoidectomy under local anesthesia versus saddle block: a multicenter randomized controlled trial

Abstract Background There is disparity in evidence on pain assessment post open hemorrhoidectomy (OH) using local anesthesia and its use in developing countries compared to developed countries. Therefore, we conducted this study to assess the occurrence of postoperative pain following open hemorrhoidectomy under local anesthesia versus saddle block for uncomplicated 3rd or 4th degree hemorrhoids. Methods This was a prospective equivalence randomized, double blind controlled trial conducted from December 2021 to May 2022 among patients with primary uncomplicated 3rd or 4th degree hemorrhoids. Pain severity was assessed at 2, 4 and 6 h post open hemorrhoidectomy using visual analogue scale (VAS). Data was analysed using SPSS version 26 at a p < 0.05 as statically significant using visual analogue scale (VAS). Results We recruited 58 participants in this study who underwent open hemorrhoidectomy under local anesthesia or saddle block (29 participants per group). The sex ratio was of 1.15 of female to male and a mean age of 39 ± 13. VAS was found to be different at 2 h post OH compare to other time of pain assessment but not statically significant by area under the cover (AUC) (95% CI = 486–0.773: AUC = 0.63; p = 0.09) with a none significance by Kruskal–Wallis’s test (p:0.925). Conclusion Local anesthesia was found to be having a similar pain severity occurrence in post operative period among patients undergoing open hemorrhoidectomy for primary uncomplicated 3rd or 4th degree hemorrhoids. Close monitoring of pain in postoperative period is mandatory especially at 2 h to assess need of analgesia. Trial registration Pan African Clinical Trials Registry, PACTR202110667430356. Registered on 8th October, 2021