An Intravenous Method of Anaesthesia for Caesarean Section. Part Ii: Ketamine

Meer, F.M.; Downing, J. W.; Coleman, A.J.

doi:10.1093/bja/45.2.191

“…Reflexes are only slightly altered, and there is a low incidence of vomiting in the recovery phase. Although ketamine has been employed as an intravenous anaesthetic for caesarean section and forceps delivery (MOORE et al 1971, MEER et al 1973, little is known about its effect on the newborn. The main disadvantage of ketamine anaesthesia is the strong tendency to psychic disturbances during the recovery period.…”

mentioning

confidence: 99%

Transplacental Passage of Ketamine after Intravenous Administration

Ellingson¹,

Haram²,

Sagen³

et al. 1977

Acta Anaesthesiol Scand

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This study was designed to measure how fast and at what concentrations ketamine would enter the foeto-placental circulation, when administered intravenously to 10 healthy mothers immediately before forceps delivery, which was indicated by a delayed second stage of labour. It is shown that ketamine very rapidly passes the placenta, and that ketamine levels in cord blood exceed the levels in the maternal venous blood as early as 1 min 37 s after the injection. The ketamine levels in cord blood reach a maximum in the period 1 min 37 s to 2 min 5 s after the injection. Later they show a tendency to decline. A short-lasting, marked elevation of blood pressure was produced by the ketamine anaesthesia. Two of the newborn showed low Apgar scores at 1 min. In one of them this was probably attributable to the anaesthesia.

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“…However, this effect can also be a serious disadvantage in cases of placental insufficiency and intrauterine hypoxia, as it may cause reduction of uterine circulation prior to delivery (MOORE et al 1971, LITTLE et al 1972. Although ketamine has been employed as an intravenous anaesthetic for caesarean section and forceps delivery (MOORE et al 1971, MEER et al 1973, little is known about its effect on the newborn. It is known that ketamine passes the placenta (LITTLE et al 1972).…”

mentioning

confidence: 99%

Transplacental Passage of Ketamine After Intravenous Administration

Ellingson

¹

,

Haram

²

,

Sagen

³

et al. 1977

Survey of Anesthesiology

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This study was designed to measure how fast and at what concentrations ketamine would enter the foeto-placental circulation, when administered intravenously to 10 healthy mothers immediately before forceps delivery, which was indicated by a delayed second stage of labour. It is shown that ketamine very rapidly passes the placenta, and that ketamine levels in cord blood exceed the levels in the maternal venous blood as early as 1 min 37 s after the injection. The ketamine levels in cord blood reach a maximum in the period 1 min 37 s to 2 min 5 s after the injection. Later they show a tendency to decline. A short-lasting, marked elevation of blood pressure was produced by the ketamine anaesthesia. Two of the newborn showed low Apgar scores at 1 min. In one of them this was probably attributable to the anaesthesia.

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“…Ketamine has been employed in obstetrics for some years (CHODOFF & STELLA 1966, STOLP et al 1968, MOORE et al 1971. The pharmacological properties of this substance have made it useful as an anaesthetic for short-lasting operations and also as an induction agent ( CORSSEN et al 1972, LITTLE et al 1973, MEER et al 1973, NETTLES et al 1973.…”

mentioning

confidence: 99%

Ketamine and Diazepam as Anaesthesia for Forceps Delivery. A Comparative Study

Ellingson

¹

,

Haram

²

,

Sagen

³

1977

Acta Anaesthesiol Scand

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In a clinically controlled trial in forceps delivery, a comparison was made between the general anaesthesia induced by ketamine and that by a combination of diazepam and N2O. Local anaesthesia was added in the diazepam group for episiotomy and suturation. The indication for operative delivery was in all cases a prolonged second stage of labour. In the katamine group, awareness was noted in four cases out of 13, even if the analgesic effect was found to be good. Four patients showed marked, short-lasting elevation of blood pressure and seven had unpleasant dreams. All thirteen mothers in the diazepam group found the anesthesia effective and the recovery pleasant. The blood pressure was stable. One mother in each group required ventilation with oxygen due to respiratory depression of short duration. Three of the children in the ketamine group and two in the diazepam group had subnormal Apgar score with slight acidosis. This was probably not attributable to the anaesthesia.

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An Intravenous Method of Anaesthesia for Caesarean Section. Part Ii: Ketamine

Cited by 30 publications

References 7 publications

Transplacental Passage of Ketamine after Intravenous Administration

Transplacental Passage of Ketamine after Intravenous Administration

Transplacental Passage of Ketamine After Intravenous Administration

Ketamine and Diazepam as Anaesthesia for Forceps Delivery. A Comparative Study

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