Incidence of oxygen desaturation during intravenous ketamine and the effects of basic airway management maneuvers on it.
- c2007.
- xiv, 58p. :
Thesis Report.
ABSTRACT:
Objectives: To evaluate and compare the incidence of oxygen desaturation during intravenous ketamine for short surgical procedure in spontaneously breathing patients and the effects of basic airway management maneuvers on it two different hilly areas of Nepal.
Design and Methodology: A population based comparative study was done at two different hospitals situated in hilly regions of Nepal, situated 1361m and 1600m above the sea level respectively. Children aged between 3 months and 14 years were observed for their oxygen saturation with the help of pulse Oximeter during intravenous ketamine anaesthesia for short surgical procedures lasting less than 15 minutes. Patients showing oxygen desaturation ( SpO2<90%) were treated with basic airway management maneuvers like chin lift, jaw thrust, physical stimulation and oropharyngeal suction initially, and oxygen was supplemented when all the maneuvers failed to improve oxygen saturation within 1 minute.
Results: 79 patients from Tansen mission hospital and 66 patients from Okhaldhunga community hospital were enrolled; the incidence of desaturation was 8(10%) and 11(16.1%) in Tansen and Okhaldhunga respectively. Among those who showed desaturation, all children from TMH and 10(90.9%) from OCH, showed desaturation within first 2 minutes of ketamine administration. 7(87.5%) and 8(72.7%) of the patients with desaturation from TMH and OCH respectively, were improved to > 90% with chin lift only and rest needed jaw thrust, but none of the patients needed physical stimulation, oropharyngeal suction, and most importantly supplemental oxygen.
Conclusion: The incidence of oxygen desaturation is common within first few minutes of ketamine administration, Basic airway like chin lift and jaw thrust is enough to improve oxygen saturation, and physical stimulation, suction is usually procedure lasting less than 15 minutes if the person giving ketamine manage the airway skillfully.