Ketamine and Diazepam as Anaesthesia for Forceps Delivery a Comparative Study

Abstract

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 N 2 0 . 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. I n the ketamine 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 anaesthesia 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.

Benzodiazepine administration during adult cardiac surgery: a survey of current practice among Canadian anesthesiologists working in academic centres

“…The earliest study compared the effect of 2 mgÁkg -1 of ketamine with 30 mg diazepam and supplemental nitrous oxide on the incidence of awareness in 26 parturients undergoing forceps delivery: 4/13 patients experienced awareness with ketamine while none did with diazepam. 25 This result may relate to the benzodiazepine, the use of nitrous oxide in the diazepam group, or the questionable equivalency of the two administered regimes. Haram et al compared the incidence of 'unpleasant recall' after induction of general anesthesia using either thiopental or diazepam in 82 parturients.…”

The incidence of unpleasant dreams after sub-anaesthetic ketamine

“…Freuchen et al 1976;Coppel et al 1973), a 'possible' association with nightmares (Pagel and Helfter 2003), all dreams being unpleasant (Figallo et al 1977), that there are more unpleasant than pleasant dreams (e.g. Krissel et al 1994;Ellingson et al 1977;Handa et al 2000), that 'terrifying dreams are infrequent' (Khorramzadeh and Lofty 1976;Lofty et al 1970) or that there are predominantly pleasant dreams (e.g. Grace 2003;Hejja and Galloon 1975;Hersack 1994;Sklar et al 1981;Sechzer 1984;Fine and Finestone 1973;Downing et al 1976;White et al 1980White et al , 1982.…”