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World Journal of Surgery

, Volume 42, Issue 9, pp 3046–3048 | Cite as

Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya When No Anesthetist is Available: Reply

  • Thomas F. Burke
  • Sebastian Suarez
  • Ayla Senay
  • Charles Masaki
  • Khama Rogo
  • Daniel I. Sessler
  • Taha Yusufali
  • Debora Rogo
  • Moytrayee Guha
  • Pankaj Jani
  • Brett D. Nelson
Reply, Letter to the Editor
  • 82 Downloads

In Reply,

Litswa and four members of the World Federation of Societies of Anaesthesiologists (WFSA) comment on our manuscript, “Safety and Feasibility of a Ketamine Package to Support Emergency and Essential Surgery in Kenya when No Anesthetist is Available: An Analysis of 1216 Consecutive Operative Procedures” [1].

Like our colleagues from the WFSA, we fully support national workforce planning and training of anesthetists in low- and middle-income countries. We urge expansion of accredited anesthetist training programs around the world. Everyone should have access to safe and timely emergency and essential surgical care when needed, which includes trained and qualified anesthetists. But, it is important to recognize that anesthetists are often unavailable in low-resource settings, the consequences of which are unnecessary death and disability [2]. Clearly, it will be at least decades before there are sufficient anesthetists in many low-resource countries.

According to the WFSA Global...

References

  1. 1.
    Burke TF, Suarez S, Senay A et al (2017) Safety and feasibility of a ketamine package to support emergency and essential surgery in Kenya when no anesthetist is available: an analysis of 1216 consecutive operative procedures. World J Surg 41:2990–2997.  https://doi.org/10.1007/s00268-017-4312-0 CrossRefPubMedGoogle Scholar
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    Meara JG, Leather AJM, Hagander L et al (2015) Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet 386(9993):569–624CrossRefPubMedGoogle Scholar
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    Kempthorne P, Morriss WW, Mellin-Olsen J et al (2017) The WFSA global anesthesia workforce survey. Anesth Analg 125(3):981–990CrossRefPubMedGoogle Scholar
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    Biccard BM, Madiba TE, Kluyts HL et al (2018) Perioperative patient outcomes in the African Surgical Outcomes Study: a 7-day prospective observational cohort study. Lancet.  https://doi.org/10.1016/S0140-6736(18)30001-1 CrossRefPubMedGoogle Scholar
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    Kenya National Bureau of Statistics (2014) Kenya Demographic and Health Survey 2015. KNBS and ICF International, NairobiGoogle Scholar
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    Bisanzo M, Nichols K, Hammerstedt H et al (2012) Nurse-administered ketamine sedation in an emergency department in rural Uganda. Ann Emerg Med 59(4):268–275CrossRefPubMedGoogle Scholar
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    Green SM, Clem KJ, Rothrock SR (1996) Ketamine safety profile in the developing world: survey of practitioners. Acad Emerg Med 3(6):598–604CrossRefPubMedGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Thomas F. Burke
    • 1
    • 2
    • 3
    • 4
  • Sebastian Suarez
    • 1
  • Ayla Senay
    • 1
  • Charles Masaki
    • 1
    • 3
    • 4
  • Khama Rogo
    • 4
    • 5
  • Daniel I. Sessler
    • 6
  • Taha Yusufali
    • 4
    • 7
  • Debora Rogo
    • 4
  • Moytrayee Guha
    • 1
    • 4
  • Pankaj Jani
    • 7
    • 8
  • Brett D. Nelson
    • 1
    • 2
    • 4
  1. 1.Division of Global Health and Human Rights, Department of Emergency MedicineMassachusetts General HospitalBostonUSA
  2. 2.Harvard Medical SchoolBostonUSA
  3. 3.Harvard T.H Chan School of Public HealthBostonUSA
  4. 4.African Institute for Health Transformation at Sagam Community HospitalLuandaKenya
  5. 5.Kenya Obstetrics and Gynaecological SocietyNairobiKenya
  6. 6.Department of Outcomes ResearchAnesthesiology Institute, Cleveland ClinicClevelandUSA
  7. 7.College of Surgery for East, Central, and Southern AfricaArushaTanzania
  8. 8.Department of SurgeryUniversity of Nairobi School of MedicineNairobiKenya

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