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Ketamine for anaesthetic induction at Caesarean section
Summary
Ketamine anesthesia for Cesarean sections may cause neonatal depression, despite adequate fetoplacental exchange. Further studies with lower ketamine doses are recommended for safer maternal and infant outcomes.
Area of Science:
- Anesthesiology
- Obstetrics
- Neonatal Medicine
Background:
- Ketamine is used for Cesarean section anesthesia.
- Its effects on neonatal outcomes and maternal-fetal acid-base balance require further investigation.
Purpose of the Study:
- To evaluate the effects of ketamine anesthesia on maternal and fetal acid-base balance during Cesarean section.
- To assess neonatal outcomes, including depression and respiratory status, following ketamine anesthesia.
Main Methods:
- Fifty healthy mothers undergoing Cesarean section received ketamine (2 mg/kg).
- Maternal and umbilical cord blood gases were analyzed.
- Neonatal status was assessed using the modified Apgar score.
Main Results:
- Eight infants showed clinical depression (modified Apgar score).
- Maternal mild respiratory alkalosis and fetal respiratory acidosis were observed.
- Prolonged delivery intervals correlated with increased acidosis and wider maternal-fetal acid-base gradients.
Conclusions:
- Ketamine maintained fetoplacental exchange but may cause neonatal depression.
- Lower ketamine dosages should be considered for Cesarean sections.
- Maternal awareness was not definitively demonstrated, though some experienced hallucinations or dreams.