Acceptability and Feasibility of an Innovative Anesthesia Technique in a Low-Resource Setting at a Rural Community Ophthalmic Center: A Prospective Journey

BACKGROUND: Ocular blindness and ocular morbidities are very much prevalent in pediatric age group in India. Mostly, these are all surgically amenable, provided they have access to safe anesthesia. Suboptimal facilities for conventional general anesthesia (GA) led to a different thought process. The combination of anesthetic and analgesic property of ketamine was utilized in a low-resource setting at a tertiary ophthalmic center for pediatric ophthalmic surgeries. AIMS: The aim of this study was to decipher whether this technique is acceptable and feasible. SETTINGS AND DESIGN: It was a prospective consecutive series at a rural eye center done over a period of 5 years. MATERIALS AND METHODS: Inclusion criterion was children undergoing eye surgeries between the ages of 7 and 18 years, who could be adequately counseled about the concept of painless intravenous cannulation and subsequent painless block. Intravenous anesthesia comprised of ketamine, in conjunction with peribulbar block. Complications of the technique, time to discharge, mean pain score, and patient and surgeon satisfaction score were documented. STATISTICAL ANALYSIS USED: Data were analyzed on Microsoft Excel. RESULTS: A total of 905 cases were conducted uneventfully without conversion to GA. No emergency resuscitation was required. The surgeon and the patient had a satisfying experience, with the technique being totally acceptable to them. CONCLUSIONS: Intravenous ketamine is an inexpensive and safe anesthetic technique when used in conjunction with regional block and is certainly a boon for minimal resource ophthalmic setup in rural India.