Dear Editor,
I have read with interest the article ‘Ketamine Anaesthesia for Gynaecological Laparoscopy’ by Lt Col PM Velankar et al [1]. I feel that the use of ketamine for gynaecological laparoscopy is indeed a very useful tool especially in small sized hospitals where facilities are not so ideal.
General anaesthesia, lithotomy position, pneumoperitoneum and steep trendelenburg are all factors which will contribute to ventilation/perfusion mismatch and consequent reduction in PaO2 [2, 3, 4]. Some amount of reduction in tissue oxygenation is inevitable when patients undergo gynaecological laparoscopy under dissociate anaesthesia with ketamine.
All operation theaters are not fortunate enough to have pulse oxymeters and in view of the facts stated above I feel that it should be MANDATORY to administer oxygen by face mask to all patients undergoing this procedure. It will do no harm to patients who do not need it but will prevent a potentially dangerous situation in those patients who need it.
REFERENCES
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