Perioperative care in children presents formidable challenges, particularly in low- to middle-income countries (LMICs) like South Africa, where high rates of morbidity and mortality demand urgent intervention. The South African Paediatric Surgical Outcomes Study (SAPSOS) and the African Paediatric Surgical Outcomes Study (ASOS-Paeds) revealed a stark contrast in surgical outcomes for children in Africa compared to high-income countries (HICs).1-3 A secondary analysis of the SAPSOS multicentre cohort highlighted a threefold increase in anaesthesia-related serious adverse events and a tenfold rise in the risk of perioperative cardiac arrest compared to HICs.4 Understanding the frequency and nature of perioperative adverse events in LMICs is essential for improving outcomes.

Private Practice, Pretoria, South Africa

Department of Anaesthesia & Perioperative Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

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