Ketamine and Midazolam Anesthesia in Surgical Operations : An Experience of Sierra Leone

Introduction: Ketamine can be used in high doses for general anesthesia and in low doses for analgesia. In this study, we aimed to present 49 patients operated under ketalar anesthesia. Materials and Methods: This study reports the results of 49 patients who were operated by Doctors Worldwide’s voluntary surgical team in the Port Loko Goverment Hospital, Sierra Leone, between 10 and 16 March 2014. The demographic characteristics of all patients and the surgical procedures performed were recorded. All patients were operated under ketamine and midazolam anesthesia. Results: 5 female and 44 male patients whose mean age was 36.8+17.8 were operated. 1 patient had umbilical, 1 had epigastric, and 35 had giant inguinal hernia. Umbilical and epigastric hernias underwent primary repair. Inguinal hernias were right-sided in 19 patients, and left-sided in 16. Twenty-eight patients had indirect hernia, while 6 had direct and 1 had bilateral hernia. No obstruction or strangulation was observed in any of the patients. Four pediatric patients with hernia underwent high ligation. In the adult age group, 28 patients underwent darn repair and 3 Bassini repair. Of the 8 patients with giant hydroceles, 4 had it on the right side and 4 on the left, and all of them were operated by Winkelmann’s technique. One patient underwent orchiectomy for a right-sided testicular mass; 1 excision of an inguinal tumor; 1 excision of a lipoma in the neck, and 1 excision of a solid mass in the left labium majus. No anesthesia-related complication developed in any of the patients. Conclusion: Safe and effective sedation achievable by intravenous administration of low-dose ketamine and midazolam is particularly useful for surgical procedures to be performed in field conditions where general anesthesia is not applicable.