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Br J Ophthalmol 2003;87:535-537 doi:10.1136/bjo.87.5.535
  • World views

Ketamine anaesthesia for paediatric ophthalmology surgery

  1. M S Pun1,
  2. J Thakur1,
  3. G Poudyal1,
  4. R Gurung1,
  5. S Rana1,
  6. G Tabin2,
  7. W V Good3 and
  8. S Ruit1
  1. 1Tilganga Eye Hospital in Kathmandu, Nepal
  2. 2Vermont, USA
  3. 3Smith-Kettlewell Eye Research Institute, San Francisco, CA, USA
  1. Correspondence to: Dr Good, Smith-Kettlewell Eye Research Institute, 2318 Filmore Street, San Francisco, CA 94115, USA; Good{at}ski.org
  • Accepted 1 October 2002

Abstract

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.

Notes

  • Series editors: W V Good and S Ruit

Responses to this article

  • An excellent alternative
    • Sudesh Shetty
    Br J Ophthalmol published online July 29, 2009
  • I did not find ketamine either safe or effective.
    • Selim T Koseoglu
    Br J Ophthalmol published online July 29, 2009

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