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Ketamine anaesthesia for paediatric ophthalmology surgery
1Tilganga Eye Hospital in Kathmandu, Nepal Vermont, USA Smith-Kettlewell Eye Research Institute, San Francisco, CA 94115, USA.
Insights
Ketamine anesthesia is safe and effective for pediatric eye surgeries in developing regions. This study found no major complications, making it a viable option where advanced anesthesia is unavailable.
Area of Science:
- Ophthalmology
- Anesthesiology
- Global Health
Background:
- Access to surgical care for children with vision-impairing conditions is limited in areas lacking anesthesia.
- Pediatric ophthalmic surgery requires safe and accessible anesthetic options, especially in resource-limited settings.
Purpose of the Study:
- To evaluate the safety and effectiveness of ketamine anesthesia for pediatric ophthalmic surgery in a developing region.
- To determine if ketamine can be used reliably in settings with limited anesthetic resources.
Main Methods:
- A consecutive series of 679 children undergoing intraocular and extraocular ophthalmic procedures were administered intravenous ketamine.
- Anesthesia was managed by a pediatrician trained in pediatric resuscitation at Tilganga Eye Hospital, Nepal.
- The study spanned a 5-year period in a developing country context.
Main Results:
- All ophthalmic procedures were completed without anesthetic complications.
- No child required unexpected resuscitation or laryngeal intubation.
- Postoperative dysphoria was occasionally observed but resolved by the first postoperative day.
Conclusions:
- Ketamine is an effective and safe anesthetic agent for pediatric intraocular and extraocular eye surgeries.
- Its simplicity and safety profile make ketamine suitable for ophthalmic procedures in developing regions with limited resources.
- Trained personnel can safely administer ketamine for short-duration ophthalmic surgeries.
Aims:
Children with treatable, vision impairing conditions may not have access to surgical care when they live in regions where anaesthesia is unavailable. The use of ketamine anaesthesia in a developing region was studied to determine its safety and effectiveness.
Methods:
This is a consecutive series of 679 children who had a variety of paediatric eye disorders necessitating a short general anaesthesia. Ketamine was administered intravenously by a paediatrician with training in paediatric resuscitation procedures. Both intraocular and extraocular procedures were performed. The location of treatment was the Tilganga Eye Hospital in Kathmandu, Nepal, a developing region of the world. The study took place over a 5 year period.
Results:
All procedures were performed without any anaesthetic complications. No child required unanticipated resuscitation or laryngeal intubation. Postoperative dysphoria occurred occasionally and was difficult to measure quantitatively. This side effect of ketamine resolved by the first postoperative day.
Conclusion:
Ketamine is an effective agent for both intraocular and extraocular surgery in the paediatric age group. None of the children in this series needed resuscitation or intubations, and the ophthalmic surgery was carried out safely. Ketamine can be used safely in any ophthalmic procedure of short duration by a person having some training in anaesthetic resuscitation procedures. Because of its simplicity and safety, ketamine may be useful in a simple ophthalmic setup in the developing word.
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