1. Evaluation of a ketamine-based anesthesia package for use in emergency cesarean delivery or emergency laparotomy when no anesthetist is available.
- Author
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Burke TF, Nelson BD, Kandler T, Altawil Z, Rogo K, Imbamba J, Odenyo S, Pinder L, Lozo S, Guha M, and Eckardt MJ
- Subjects
- Adolescent, Adult, Aged, Aged, 80 and over, Emergencies, Female, Hallucinations chemically induced, Humans, Kenya, Male, Maternal Mortality, Middle Aged, Pregnancy, Prospective Studies, Young Adult, Analgesics administration & dosage, Anesthesia, Obstetrical methods, Cesarean Section, Ketamine administration & dosage, Laparotomy
- Abstract
Objective: To assess the safety of a ketamine-based rescue anesthesia package to support emergency cesarean delivery and emergency laparotomy when no anesthetist was available., Methods: A prospective case-series study was conducted at seven sub-county hospitals in western Kenya between December 10, 2013, and January 20, 2016. Non-anesthetist clinicians underwent 5days of training in the Every Second Matters-Ketamine (ESM-Ketamine) program. A database captured preoperative, intraoperative, and postoperative details of all surgeries in which ESM-Ketamine was used. The primary outcome measure was the ability of ESM-Ketamine to safely support emergency operative procedures., Results: Non-anesthetist providers trained on ESM-Ketamine supported 83 emergency cesarean deliveries and 26 emergency laparotomies. Ketamine was administered by 10 nurse-midwives and six clinical officers. Brief oxygen desaturations (<92% for <30s) were recorded among 5 (4.6%) of the 109 patients. Hallucinations occurred among 9 (8.3%) patients. No serious adverse events related to the use of ESM-Ketamine were recorded., Conclusion: The ESM-Ketamine package can be safely used by trained non-anesthetist providers to support emergency cesarean delivery and emergency laparotomy when no anesthetist is available., (Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2016
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