Operations supported by ketamine anesthesia in resource-limited settings: Surgeons’ perceptions and recommendations

Prior to the COVID-19 pandemic, ketamine's wide safety margin led to its use as a sole anesthetic agent in resource-limited settings when no anesthetist was available. During the pandemic, the use of ketamine has increased, however there are few recommendations on approaches to intraoperative challenges associated with ketamine's unique properties. The objective of this study was to gain surgeons' perceptions on performing operations supported by ketamine and to recommend best practices and techniques.

Sixteen surgeons were interviewed regarding their operative experiences supported by ketamine across 12 countries. Surgeons universally felt that ketamine is safe, saves lives, and that they would administer it to a loved one in support of an operation if no anesthetist was available. They confirmed that it requires few surgical technical changes. The paper suggests surgeons advocate for global policies, training and access on use of ketamine, and recommends that global standards on ketamine training and use are established.