摘要：

Ketamine, first prescribed for clinical use in 1965,1 is usedrnfrequently in developing countries as an intravenousrnanaesthetic agent for surgery. It is used as an anaestheticrnfor paediatric eye surgery,2–4 with favourable results. Inrnthese studies, ketamine was administered to babies orrnchildren, venous access was obtained and a pulse oximeterrnwas used to monitor vital signs. Many hospitals inrndeveloping nations are remote and under-funded. Fullyrnqualified specialists sent there to work often do not havernthe basic medical equipment they require. Our eye centrernin Fianarantsoa, Madagascar, is staffed by three trainedrnophthalmologists, including a paediatric ophthalmologist,rnplus two ophthalmology residents and a paediatricianrntrained in paediatric resuscitation procedures. However,rnup to the present time, general anaesthesia services havernnot been available. There are no pulse oximeters, andrnsupplies for placement of venous lines are lacking.rnTherefore, with close monitoring by the paediatrician,rnketamine anaesthesia is given by intramuscular injectionrnto children requiring eye surgery, without the use ofrnvenous lines or pulse oximeters. We describe ourrnexperience with 29 consecutive paediatric eye proceduresrnperformed under our care. To our knowledge, this is thernfirst report of the routine use of intramuscular ketaminernanaesthesia for paediatric eye surgery without the placementrnof a peripheral venous line, or the use of a pulsernoximeter.

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