A ketamine package for use in emergency cesarean delivery when no anesthetist is available
An analysis of 401 consecutive operations
Abstract
The purpose of this research was to evaluate the safety and effectiveness of a ketamine-based anaesthesia package to support emergency caesarean section when no anaesthetist is available.
A prospective case-series was conducted across 9 sub-county hospitals in Kenya. A total of 401 emergency caesarean sections were performed using ketamine, administered by 54 non-anaesthetist providers (who had undertaken a five-day training course). All mothers survived to discharge. Brief oxygen desaturations were recorded among only eight percent of mothers, and agitation and hallucinations occurred among just three percent. There were no maternal serious adverse events. At six-month follow-up, 94.2% of mothers who could be reached reported no complaints.
The results indicate that a ketamine-based anaesthesia package is safe and effective when used by trained non-anaesthetist providers to support emergency caesarean sections, when no anaesthetist is available. Ketamine has significant potential to increase access to emergency caesarean deliveries in resource-limited settings.”
This research was supported by the Research for Health in Humanitarian Crises (R2HC) Programme.
Citation
Burke, TF, Mantena, S, Opondo, K, Orero, S, Rogo, K. A ketamine package for use in emergency cesarean delivery when no anesthetist is available: An analysis of 401 consecutive operations. Int J Gynecol Obstet. 2022; 158: 377– 384. doi:10.1002/ijgo.13965