Ketamine facing potential Ban- join the survey

I got this as a  GIEESC member and would like to share it with my readers especially Anesthetic nurses.
A serious current issue regarding Ketamine is that the Commission on Narcotics Drugs (CND), in Vienna poses a significant threat of international scheduling because of its recreational use in some countries. One country in particular is vigorously pushing to greatly restrict Ketamine. Historic precedence with narcotics, for example in India, demonstrates severe constraints on availability if international scheduling occurs. Presently Ketamine is on the WHO Essential Medicines List and is often the only anaesthetic available, particularly in LMICs and disaster settings. Currently in LMICs, it is used in 90% of C-sections and 95% of procedures in trauma centres. Ketamine is cost effective as it is not dependent on infrastructure, water or electricity supply, and less demanding of airway precautions. There is a risk that if Ketamine becomes unavailable, surgical care will suffer greatly or cease entirely in many low and middle-income countries.

As part of an advocacy campaign, we would like to collect data on how much Ketamine is used in your own hospital for any procedures and how much Ketamine is used in your country. We believe this data will help the argument that Ketamine is essential to surgical care around the world. There are several simple questions below. Please complete the questionnaire to the best of your ability and return to me by email at your earliest convenience.

In the meantime, we all need to be actively involved to promote awareness of Ketamine’s importance to surgical care.

Ketamine Use Questionnaire

1.    How many patients in your hospitals, private clinics, are treated with medical products containing ketamine in the past year (specify year) in your country for Caesarean sections, exploratory laparotomy, and for reducing fractures?
_ 0 (i.e., ketamine is not used)
_ 1-99
_ 100-999
_ 1000-5000
_ > 5000
_don’t know

2.    How many patients in your country are treated with medical products containing ketamine in the past year (specify year) in your country for Caesarean sections, exploratory laparotomy, and for reducing fractures?
_ 0 (i.e., ketamine is not used)
_ 1-99
_ 100-999
_ 1000-5000
_ > 5000
_don’t know

3.    Approximately how many patients have you treated with ketamine in the past year for:
a.    Caesarean sections?
b.    Exploratory laparotomy?
c.    Reducing fractures?
d.    Other (please specify)?

4.    Why would you choose to use ketamine over another agent?

5.    What percentage of surgical cases in your hospital are performed with Ketamine?

6.    What percentage of surgical cases in your country are performed with Ketamine?

7.    What treatment protocol using ketamine is usual for:
a.    Caesarean sections?
b.    Exploratory laparotomy?
c.    Reducing fractures?
d.    Other (please specify)?

8.    In which situations or clinical settings can ketamine be the anaesthetic, sedative or analgesic agent of choice (check all that apply)?
_ Emergency situations
_ Conducting procedures with paediatric patients
_ Short surgical procedures
_ Long surgical procedures
_ Surgery conducted outside a hospital without respiratory support facilities
_ Other.....................................................................................       
 
Please return by copy/paste to the survey owner at: johnsonw@who.int
or contact him with the information below.
Very sincerely,

Walter D Johnson, MD, MBA, MPH, FACS 

Emergency & Essential Surgical Care Programme Lead
Service Delivery and Safety Department 

World Health Organization- HQ 

20 Avenue Appia, CH121, Geneva 27, Switzerland 

+41 22 791 4011;  johnsonw@who.int; www.who.int/surgery