Safety profile of parenteral ketamine and lignocaine infiltration in pediatric operations.
OBJECTIVE
To study the safety and benefits of parenteral ketamine and lignocaine infiltration among pediatric surgical patients with co-morbidities that would preclude the use of general anesthesia requiring endotracheal intubation/face mask in a developing country.


METHODS
This prospective study was undertaken at the Leadeks Medical Centre, Benin City Edo State, Nigeria between January 2002 and December 2006. Patients requiring surgery were safely operated even in the presence of co-morbidity.


RESULTS
A total of 416 children were recruited and they were aged 6 days to 16 years (mean 12 -/+ 2.04 years) with a male/female ratio of 1:1.1. Appendectomy (33.2%), herniotomy (20.2%) and suturing of laceration (15.9%) were the most common indications for surgery. Anemia, upper respiratory tract infections, malnutrition, malaria fever, typhoid fever, and retroviral infections were co-morbidities. Ambulatory surgery was carried out in 48.6% patients. Overall, only 23.3% experienced postoperative pain, which was statistically significant in those that had laparotomy and appendectomy (p<0.0001), and analgesics such as paracetamol were enough to relieve the pain. Complications recorded such as postoperative vomiting, emergence reaction, wound infection, post operative fever, and apnea occurring after ketamine injections were tolerated and no mortality was recorded.


CONCLUSIONS
The satisfactory anesthesia and analgesia recorded with this combination, and the low complications observed in the presence of co-morbidity showed that these agents have much to offer in a developing country.
Osifo
David O
DO
Department of Surgery, Pediatric Surgery Unit, University of Benin, Teaching Hospital, Benin City, Nigeria. Leadekso@yahoo.com
Emeagui
Kennedy N
KN
Aghahowa
Sylvester E
SE
D000293:Adolescent; D000778:Anesthetics, Dissociative / Q000008:administration & dosage* / Q000009:adverse effects; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007649:Ketamine / Q000008:administration & dosage* / Q000009:adverse effects; D008012:Lidocaine / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D009549:Nigeria; D011446:Prospective Studies; D013514:Surgical Procedures, Operative
D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D007649:Ketamine; D008012:Lidocaine