Key result
The ESM-Ketamine package used by non-anesthetist clinicians for obstetric and gynecologic surgeries was safe, with no ketamine-related deaths or injuries and only 0.4% prolonged oxygen desaturations.
Why the study?
The study assessed the feasibility and safety of the ESM-Ketamine package to support obstetric and gynecologic emergency and essential surgery when no anesthetist is available.
Does the ESM-Ketamine package provide safe anesthesia support for obstetric and gynecologic procedures in resource-limited settings without anesthetists?
Observational (n=530)
Yes
Does the ESM-Ketamine package provide safe anesthesia support for obstetric and gynecologic procedures in resource-limited settings without anesthetists?
The ESM-Ketamine package appears feasible and safe for obstetric and gynecologic surgeries in resource-limited settings lacking anesthetists.
Answers are grounded in this paper and cite their sources.
Supports feasibility of non-anesthetist ketamine use for obstetric surgery in resource-limited Kenya; leaves open confirmation in larger trials.
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.
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Masaki et al. (2019) conducted an observational in Obstetric and gynecologic emergency and essential surgery (n=530). ESM-Ketamine package was evaluated on Reasons for ESM-Ketamine activations and ketamine-related adverse events. The ESM-Ketamine package used by non-anesthetist clinicians for obstetric and gynecologic surgeries was safe, with no ketamine-related deaths or injuries and only 0.4% prolonged oxygen desaturations.
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