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Related Experiment Videos

Ketamine and diazepam as anaesthesia for forceps delivery. A comparative study.

A Ellingson, K Haram, N Sagen

    Acta Anaesthesiologica Scandinavica
    |January 1, 1977
    PubMed
    Summary

    Diazepam and nitrous oxide general anesthesia proved more effective and pleasant for forceps delivery than ketamine, with fewer adverse effects like awareness and blood pressure changes.

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    Area of Science:

    • Obstetrics and Gynecology
    • Anesthesiology
    • Clinical Trials

    Background:

    • Operative vaginal delivery, such as forceps delivery, requires effective anesthesia.
    • General anesthesia options for obstetric procedures include ketamine and combinations like diazepam with nitrous oxide (N2O).

    Purpose of the Study:

    • To compare the efficacy and maternal/neonatal outcomes of ketamine general anesthesia versus diazepam and N2O general anesthesia with local infiltration for forceps delivery.

    Main Methods:

    • A clinically controlled trial compared ketamine general anesthesia with diazepam and N2O general anesthesia (plus local for episiotomy/suturing) in 26 women undergoing forceps delivery for prolonged second stage of labor.
    • Maternal awareness, blood pressure, recovery experience, and need for respiratory support were assessed.

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  • Neonatal Apgar scores and acid-base status were evaluated.

    • Main Results:

    • Ketamine group (n=13): 4 cases of awareness, good analgesia, 4 with transient hypertension, 7 with unpleasant dreams. Diazepam group (n=13): All found anesthesia effective and recovery pleasant, stable blood pressure.
    • One mother in each group required brief oxygen ventilation for respiratory depression.
    • Neonatal outcomes (Apgar scores, acidosis) were similar and likely unrelated to anesthesia.

    Conclusions:

    • Diazepam and N2O general anesthesia offers a more favorable maternal experience with stable hemodynamics compared to ketamine for forceps delivery.
    • Both anesthetic techniques demonstrated minimal, transient adverse effects on neonates in this study.