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In many parts of the world, there is no choice: ketamine is often the only anesthetic at hand. Ketamine is extremely safe because, unlike other anesthetic agents, it does not depress breathing or blood pressure. This means it is relatively easy to administer and is an excellent anesthetic for patients who have lost a lot of blood or who have dangerously low blood flow due to septic shock. Ketamine’s high level of safety also makes it unique amongst other anesthetics, as it does not require reliable electricity supply, oxygen, highly trained staff or monitoring systems to administer. That makes it critical in surgery in low- and middle-income countries and in conflict and disaster zones where such resources are often unavailable. Ketamine is frequently used in severely injured people and appears to be safe.

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