Ketamine as induction agent for caesarean section.

A series of 100 patients undergoing caesarean section was studied using ketamine 1.2 mg/kg as induction agent. Fifteen minutes prior to induction, atropine 0.25-0.5 mg and diazepam 1 mg was given intravenously as premedication. Anaesthesia was maintained with N2O:O2, FIO2 0.4. Once the umbilical cord was clamped, 0.2 mg fentanyl and 9 mg diazepam was given intravenously. Except for nitrous oxide, no more anaesthetic intravenous or inhalational agent was needed. Despite the fact that patients with known intrauterine asphyxia before the induction were included in the material, we found excellent Apgar scores (mean 9.1 at 1 min and 9.9 at 5 min). None of the patients reported awareness during the operation. Eight patients experienced pleasant dreams and three unpleasant. There were no hallucinations in the recovery area. The mental condition of the mothers after the operation was acceptable. It is suggested that ketamine can be used not only on special indications but also as a routine method for induction of anaesthesia for caesarean section.