1. Feasibility of a Ketamine Anesthesia Package in Support of Obstetric and Gynecologic Procedures in Kenya When No Anesthetist is Available.
- Author
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Masaki CO, Makin J, Suarez S, Wuyke G, Senay AN, Suarez-Rebling D, Imbamba J, Juma J, Guha M, and Burke TF
- Subjects
- Anesthesia adverse effects, Anesthetics, Dissociative adverse effects, Emergency Service, Hospital, Feasibility Studies, Female, Humans, Kenya, Ketamine adverse effects, Outcome Assessment, Health Care, Pregnancy, Anesthesia methods, Anesthetics, Dissociative administration & dosage, Emergencies, Ketamine administration & dosage
- Abstract
The objective was to assess the feasibility and safety of the ̳Every Second Matters for Emergency and Essential Surgery - Ketamine' (ESM-Ketamine) package in support of obstetric and gynecologic emergency and essential surgery when no anesthetist is available. A consecutive case series was conducted in twelve hospitals across five severely resource-limited counties in Kenya. 530 women underwent obstetric or gynecological operative procedures supported by non-anesthetist clinicians using the ESM-Ketamine package between November 1, 2013 and September 30, 2017. Main outcomes included reasons for ESM-Ketamine activations and ketamine-related adverse events. There were two (0.4%) prolonged (>30 seconds) oxygen desaturations below 92%. Brief oxygen desaturations (<30 seconds) below 92% occurred in 15 (2.8%) cases and 113 (21.3%) were administered diazepam to treat hallucinations or agitation. There were no ketamine-related deaths or injuries. The ESM- Ketamine package appears feasible and safe for use in support of obstetric and gynecologic surgeries when no anesthetist is available.
- Published
- 2019
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