Anesthesia care in a medium-developed country: a nationwide survey of Mongolia

Study Objective: To evaluate the current status of anesthesia and its allied disciplines in Mongolia. Design: Nationwide questionnaire survey. Setting: Two university hospitals. Measurements: A total of 44 hospitals that include a department of surgery and that were registered at the Mongolian Ministry of Health were queried. The questionnaire included 44 questions in two sections. The first section consisted of 6 general questions about the hospital, and the second section included 40 questions on anesthesia and perioperative patient care. The Mann-Whitney U-test, Chi(2)-tests, and a bivariate correlation analysis were used for statistical analysis. Main Results: 44 (100%) questionnaires were returned. Twenty-two (50%) hospitals were located in the capital city of Ulaanbaatar. Nine hundred (median; interquartile range: 413-1,468) surgical interventions were performed annually in the study hospitals. Physician anesthesiologists delivered anesthesia in all hospitals. Techniques for general anesthesia included endotracheal intubation (95.5%), laryngeal mask ventilation (13.6%), mask ventilation (27.3%), dissociative ketamine anesthesia (84.1%), and combined general/regional anesthesia (63.6%). Regional anesthetic techniques included spinal (97.7%), epidural (43.2%), axillary plexus (40.9%), peripheral nerve (13.6%), and local anesthesia (15.9%). The most frequently used hypnotics were ketamine (86.4%) and thiopental sodium (70.5%). Halothane was available in all hospitals. Oxygen was available during anesthesia in 95.5% of hospitals. The most widely available intraoperative monitoring equipment were a stethoscope (84.1%), oximeter (81.8%), and sphygmomanometer (84.1%). A recovery room was available in 22 (50%) hospitals. Conclusions: Anesthesia is an underdeveloped and under-resourced medical specialty in Mongolia. (C) 2010 Elsevier Inc. All rights reserved.