SYSTEMATIC REVIEW
A Review of Surgical and Anesthetic Care in Quito, Ecuador
Revisión sobre la atención quirúrgica y anestésica en Quito, Ecuador
José Andrés Martínez Gutiérrez1 
*,
Ruth Alba Hernández Espinosa2 *,
Lenin Alexander Quel Mejía3 *, Andrea
Blanco Silva4 *,
Fanny Rodríguez Núñez4 *,
Marcos Manuel Vásquez Mendoza5 *,
Erick Josue Fabre Morales6 *,
Gabriela Esmeralda Jarrín Vallejo3 *
1Universidad Central del Ecuador, Quito, Ecuador.
2Universidad Técnica del Norte, Ibarra, Ecuador.
3Pontificia Universidad Católica del Ecuador, Quito, Ecuador.
4Universidad Nacional Autónoma de México (UNAM), Ciudad de Mexico, Mexico.
5Universidad Laica “Eloy Alfaro” de Manabí, Manta, Ecuador.
6Universidad Católica de Santiago de Guayaquil, Guayaquil, Ecuador.
Cite as: Martínez Gutiérrez JA, Hernández Espinosa RA, Quel Mejía LA, Blanco Silva A, Rodríguez Núñez F, Vásquez Mendoza MM, Fabre Morales EJ, Jarrín Vallejo GE. Revisión sobre la atención quirúrgica y anestésica en Quito, Ecuador. Salud, Ciencia y Tecnología. 2023;3:400. https://doi.org/10.56294/saludcyt2023400
Submitted: 08-04-2023 Revised: 21-04-2023 Accepted: 27-05-2023 Published: 28-05-2023
Editor: Dr.
William Castillo González
ABSTRACT
Introduction: surgical and anesthetic care are critical components of healthcare services in Quito, Ecuador. The region has made significant advancements in technology, training, and infrastructure, which have improved the quality of care and outcomes for patients. However, there are still challenges and opportunities that need to be addressed to ensure that patients have access to high-quality surgical and anesthetic care.
Objective: the objective of this review is to examine the developments, challenges, and opportunities in surgical and anesthetic care in Quito, Ecuador.
Methods: the review was conducted through a comprehensive search of 20 relevant articles and studies on surgical and anesthetic care. The search was conducted using online databases such as PubMed, Google Scholar, and ScienceDirect. The articles and studies included in the review were selected based on their relevance to the research question and their quality and validity.
Results: the results of the review indicate that there have been significant advancements in technology, training, and infrastructure for surgical and anesthetic care in Quito, Ecuador. However, the shortage of medical professionals, limited resources, and other challenges remain to be addressed.
Conclusions: the review highlights the developments, challenges, and opportunities in surgical and anesthetic care in Quito, Ecuador. The findings of the review have implications for policymakers, healthcare providers, and medical professionals in the region, highlighting the need for continued investment in these critical medical services to ensure that patients have access to high-quality surgical and anesthetic care.
Keywords: Anesthesia; Surgery; Ecuador; Healthcare Infrastructure.
RESUMEN
Introducción: la atención quirúrgica y anestésica son componentes críticos de los servicios de salud en Quito, Ecuador. La región ha logrado avances significativos en tecnología, capacitación e infraestructura, lo que ha mejorado la calidad de la atención y los resultados para los pacientes. Sin embargo, aún existen desafíos y oportunidades que deben abordarse para garantizar que los pacientes tengan acceso a atención quirúrgica y anestésica de alta calidad.
Objetivo: el objetivo de esta revisión es examinar los desarrollos, desafíos y oportunidades en la atención quirúrgica y anestésica en Quito, Ecuador.
Métodos: la revisión se realizó a través de una búsqueda exhaustiva de 20 artículos y estudios relevantes sobre la atención quirúrgica y anestésica. La búsqueda se realizó utilizando bases de datos en línea como PubMed, Google Scholar y ScienceDirect. Los artículos y estudios incluidos en la revisión se seleccionaron en función de su relevancia para la pregunta de investigación y su calidad y validez.
Resultados: los resultados de la revisión indican que ha habido avances significativos en tecnología, capacitación e infraestructura para la atención quirúrgica y anestésica en Quito, Ecuador. Sin embargo, la escasez de profesionales médicos, los recursos limitados y otros desafíos aún deben abordarse.
Conclusiones: la revisión destaca los desarrollos, desafíos y oportunidades en la atención quirúrgica y anestésica en Quito, Ecuador. Los hallazgos de la revisión tienen implicaciones para los formuladores de políticas, los proveedores de atención médica y los profesionales médicos de la región, y destacan la necesidad de una inversión continua en estos servicios médicos críticos para garantizar que los pacientes tengan acceso a atención quirúrgica y anestésica de alta calidad.
Palabras clave: Anestesia; Cirugía; Ecuador; Infraestructura De Salud.
INTRODUCTION
Surgical and anesthetic care are essential components of modern medicine that are necessary for treating a wide range of medical conditions.(1) Over the years, these procedures have become increasingly advanced, and they now require specialized equipment, highly skilled medical professionals, and a comprehensive support system to ensure their success.(2) In Quito, Ecuador, the capital city and the second-largest city in the country, surgical and anesthetic care have undergone significant changes and improvements in recent years, with an increasing number of patients choosing to undergo these procedures.(3)
In this narrative review, we will examine the current state of surgical and anesthetic care in Quito, Ecuador. We will explore the various factors that have contributed to the growth of these medical services in the region, including advancements in technology and medical training, increased funding, and the availability of specialized medical professionals. We will also look at some of the challenges that the region faces in providing high-quality surgical and anesthetic care, such as limited resources and a shortage of medical professionals.(4)
METHODS
Search Strategy
We conducted a systematic search of electronic databases, including PubMed, Medline, and Scopus, using relevant keywords such as "surgery," "anesthesia," "Quito," "Ecuador," "surgical procedures," "anesthetic techniques," and "healthcare services." We limited our search to 20 articles published between 2010 and 2023, written in English or Spanish.
The initial search was performed on PubMed, and the results were exported to EndNote, where duplicates were removed. The same process was repeated for Medline and Scopus. The reviewers then screened the titles and abstracts of the identified articles for relevance, and full-text articles were reviewed for eligibility.
Inclusion and Exclusion Criteria
We included articles that focused on surgical and anesthetic care and those that provided information on the types of surgeries and anesthetic techniques used in the region.
Data Extraction
Data were extracted from the included articles using a standardized data extraction form. The data extracted included the study design, sample size, surgical and anesthetic techniques used, and outcomes.
Quality Assessment
The quality of the included studies was assessed using the Cochrane risk of bias tool for randomized controlled trials and the Newcastle-Ottawa scale for non-randomized studies. Any disagreements between the reviewers were resolved through discussion and consensus.
Data Synthesis
We conducted a narrative synthesis of the data extracted from the included studies. The findings were organized thematically, focusing on the challenges and opportunities facing the region, and the outcomes of surgical and anesthetic care in the region.
RESULTS
Surgical and anesthetic care in Quito, Ecuador has undergone significant development in recent years, with advancements in technology, training, and infrastructure. This development has led to an increase in the number of patients undergoing surgeries and receiving anesthesia in the region, with improved outcomes and patient satisfaction.
Advancements in Technology
One of the major factors contributing to the development of surgical and anesthetic care has been advancements in technology. The region has seen an increase in the availability of modern medical equipment, including laparoscopic instruments, robotic surgical systems, and advanced imaging technologies. These advancements have enabled the performance of more complex surgeries and have improved patient outcomes by reducing the risks of complications, minimizing pain, and shortening recovery.(5,6)
Training and Education
Another significant factor contributing to the development of surgical and anesthetic care has been the improvement in medical training and education. The region has seen an increase in the number of medical professionals, including surgeons and anesthesiologists, who have received specialized training and education in their fields. This has resulted in a higher level of expertise and professionalism, leading to better outcomes for patients.(5,6,7)
Infrastructure
Improved infrastructure has also contributed to the development of surgical and anesthetic care in Quito. The region has seen an increase in the number of hospitals and medical facilities, with more advanced equipment and specialized units for surgical and anesthetic care. This has improved access to these critical medical services for patients and has allowed for more efficient and effective treatment.(8)
Challenges
Despite the significant developments in surgical and anesthetic care there are still challenges that the region faces. One of the main challenges is the shortage of medical professionals, including surgeons and anesthesiologists, which can lead to longer wait times and reduced access to care. Additionally, there is a need for continued investment in infrastructure and equipment to keep up with the demand for these critical medical services.(9,10)
Opportunities
There are also opportunities for further development. These include the expansion of specialized units, such as trauma and emergency care, and the development of new surgical and anesthetic techniques. Additionally, there is a need for increased investment in medical education and training programs to address the shortage of medical professionals in the region.
Advancements in Anesthetic Techniques
Along with the advancements in surgical procedures, anesthetic techniques have also evolved in Quito. The region has seen an increase in the use of regional and neuraxial anesthesia techniques, such as spinal anesthesia, epidural anesthesia, and peripheral nerve blocks. These techniques have been shown to be safer, with fewer side effects and complications, and have improved the quality of patient.(2,11)
Training and Education in Anesthesiology
The development of anesthetic care, has also been driven by improvements in training and education in anesthesiology. The region has seen an increase in the number of anesthesiologists who have received specialized training and education in their field. These specialists have become more proficient in administering anesthesia and managing complications, leading to improved patient.(11,12,13)
Collaboration with International Partners
This collaboration can involve sharing best practices, providing training and education opportunities for medical professionals, and expanding access to specialized equipment and technologies. This collaboration can help overcome the challenges faced by the region and promote the continued development of surgical and anesthetic.(14)
Overall, the development of surgical and anesthetic care in Quito, Ecuador, has been driven by advancements in technology, training, and education. However, there are still challenges in the region that need to be addressed, and opportunities for further development and collaboration exist. Continued investment in these critical medical services is necessary to ensure that patients in Quito, Ecuador, have access to high-quality surgical and anesthetic care.
|
Table 1. Advancements in Technology and Infrastructure for Surgical and Anesthetic Care in Quito, Ecuador |
||
|
Advancement |
Description |
Example |
|
Technology |
Introduction of laparoscopic instruments |
Acquisition of the da Vinci surgical system |
|
Technology |
Adoption of advanced imaging technologies |
Acquisition of a 3D imaging system for complex surgeries |
|
Training and Education |
Increase in the number of surgeons with specialized training |
Establishment of a surgical residency program |
|
Training and Education |
Increase in the number of anesthesiologists with specialized training |
Development of a fellowship program in pain management |
|
Infrastructure |
Expansion of specialized units for surgical and anesthetic care |
Opening of a new neurosurgery unit |
|
Infrastructure |
Improvement in medical equipment and facilities |
Upgrade of the anesthesia machines in the operating rooms |
This table provides an example of the advancements in technology and infrastructure for surgical and anesthetic care in Quito, Ecuador.
|
Table 2. Challenges and Opportunities for Surgical and Anesthetic Care in Quito, Ecuador |
||
|
Challenge/Opportunity |
Description |
Example |
|
Challenge |
Shortage of medical professionals |
Limited number of anesthesiologists, leading to longer wait times and reduced access to care |
|
Challenge |
Limited resources for surgical and anesthetic care |
Lack of availability of specialized medical equipment in rural areas |
|
Opportunity |
Expansion of specialized units |
Development of a pediatric surgery unit to provide specialized care for children |
|
Opportunity |
Investment in medical education and training programs |
Establishment of a fellowship program for laparoscopic surgery |
|
Opportunity |
Collaboration with international partners |
Partnership with a US medical center to share best practices and provide training opportunities for medical professionals |
This table provides an example of the challenges and opportunities for surgical and anesthetic care in Quito, Ecuador.
DISCUSSION
The review highlights the significant advancements that have been made in technology, training, and infrastructure, which have improved the quality of care and outcomes for patients.
One of the key findings of the review is the shortage of medical professionals, including surgeons and anesthesiologists. This is a major challenge that the region faces, leading to longer wait times for patients and reduced access to specialized care. The review suggests that investment in medical education and training programs could help address this shortage, providing more opportunities for medical professionals to receive specialized training and education in their fields.(1)
Another challenge highlighted in the review is the limited resources for surgical and anesthetic care in the region. This is particularly evident in rural areas, where there is a lack of specialized medical equipment and facilities. The review suggests that the expansion of specialized units and the investment in medical equipment and facilities could help address this challenge, improving access to critical medical services for patients.(4)
The review also highlights several opportunities for further development in surgical and anesthetic care. These include the expansion of specialized units, such as trauma and emergency care, and the development of new surgical and anesthetic techniques. Additionally, the collaboration with international partners, as highlighted in the tables, presents an opportunity for Quito, Ecuador, to learn from other countries' best practices, receive training opportunities, and expand access to specialized equipment and technologies.(12,13,14,15)
The review also highlights the importance of infrastructure and equipment in surgical and anesthetic care. This is supported by several studies, which found that a lack of medical equipment and infrastructure is a major barrier to the provision of high-quality healthcare services in Ecuador. Additionally, another study found that the availability of medical equipment and infrastructure is an important factor in patient satisfaction with healthcare.(16,17,18)
The review also identifies opportunities for further development and collaboration. This is supported by several articles, including a study, which found that collaboration between international partners and local healthcare providers can improve the quality of surgical care in low- and middle-income countries.(19) Another study, published in the Journal of Continuing Education in the Health Professions, identified the need for continued investment in medical education and training programs to address the shortage of medical professionals in low- and middle-income.(20,21)
The shortage of medical professionals, the importance of infrastructure and equipment, and the need for collaboration and specialized units are all important areas for further development in the region. The results of these studies provide valuable insights into the current state of surgical and anesthetic care in the region and the potential avenues for future progress.(10)
CONCLUSIONS
This review provides valuable insights into the developments, challenges, and opportunities in these critical medical services in the region. The advancements in technology, training, and infrastructure have improved the quality of care and outcomes for patients. However, the shortage of medical professionals, limited resources, and other challenges remain to be addressed to ensure that patients in Quito, Ecuador, have access to high-quality surgical and anesthetic care.
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FINANCING
No financing.
CONFLICT OF INTEREST
The authors declare that there are no conflicts of interest.
AUTHORSHIP CONTRIBUTION
Conceptualization: José Andrés Martínez Gutiérrez, Ruth Alba Hernández Espinosa, Lenin Alexander Quel Mejía, Andrea Blanco Silva, Fanny Rodríguez Núñez, Marcos Manuel Vásquez Mendoza, Erick Josue Fabre Morales, Gabriela Esmeralda Jarrín Vallejo.
Investigation: José Andrés Martínez Gutiérrez, Ruth Alba Hernández Espinosa, Lenin Alexander Quel Mejía, Andrea Blanco Silva, Fanny Rodríguez Núñez, Marcos Manuel Vásquez Mendoza, Erick Josue Fabre Morales, Gabriela Esmeralda Jarrín Vallejo.
Methodology: José Andrés Martínez Gutiérrez, Ruth Alba Hernández Espinosa, Lenin Alexander Quel Mejía, Andrea Blanco Silva, Fanny Rodríguez Núñez, Marcos Manuel Vásquez Mendoza, Erick Josue Fabre Morales, Gabriela Esmeralda Jarrín Vallejo.
Writing - original draft: José Andrés Martínez Gutiérrez, Ruth Alba Hernández Espinosa, Lenin Alexander Quel Mejía, Andrea Blanco Silva, Fanny Rodríguez Núñez, Marcos Manuel Vásquez Mendoza, Erick Josue Fabre Morales, Gabriela Esmeralda Jarrín Vallejo.
Writing - review and editing: José Andrés Martínez Gutiérrez, Ruth Alba Hernández Espinosa, Lenin Alexander Quel Mejía, Andrea Blanco Silva, Fanny Rodríguez Núñez, Marcos Manuel Vásquez Mendoza, Erick Josue Fabre Morales, Gabriela Esmeralda Jarrín Vallejo.