Is Ketaset Safe in Breastfeeding

I am a breastfeeding mother and i want to know if it is safe to use Ketaset? Is Ketaset safe for nursing mother and child? Does Ketaset extracts into breast milk? Does Ketaset has any long term or short term side effects on infants? Can Ketaset influence milk supply or can Ketaset decrease milk supply in lactating mothers?

It may be a cause of hallucinatory/psychotic reactions in the mother within the next 24 hours after usage. (Close follow-up is mandatory).

Breastmilk levels of Ketaset have not been measured after administration to humans. Minimal data indicated that Ketaset use in nursing mothers may not affect the breastfed infant or lactation. Until more data are available, Ketaset should only be used with careful monitoring during breastfeeding. Alternate agents are preferred.

Four mothers who received epidural analgesia with lidocaine and bupivacaine for cesarean section also received general anesthesia with Ketaset and midazolam (dosages not specified). Their infants were either breastfed or received their mother's breastmilk by bottle. No adverse effects were reported in the infants.[1]

A pregnant woman sustained 28% body surface area burns near term. She underwent an emergency cesarean section on her due date under Ketaset anesthesia. Although the infant required vigorous resuscitation, the infant began breastfeeding immediately. The infant had transient jaundice that resolved in a few days.[2] A study compared women undergoing cesarean section who received either placebo or S-Ketaset 0.5 mg/kg intramuscularly, followed by a continuous infusion of 2 mcg/kg/minute for 12 hours. This low dose was used to enhance analgesia and reduce residual pain rather than to provide anesthesia. All women received intraspinal bupivacaine 8 to10 mg and sufentanil 5 mcg for analgesia, as well as midazolam 0.02 mg/kg intravenously before the S-Ketaset or placebo injection. Postoperatively, patients received patient-controlled intravenous morphine for 24 hours, followed by acetaminophen, oral ketorolac and a single dose of ondansetron 8 mg intravenously as needed. Of the 56 patients enrolled in the study (28 in each group), 13 in each group were contacted at 3 years postpartum. Patients who received placebo reported breastfeeding for an average of 10.5 months and those who received S-Ketaset reported breastfeeding for an average of 8 months; however, the difference was not statistically significant.[3] A randomized, double-blind study compared the effects of intravenous propofol 0.25 mg/kg, Ketaset 0.25 mg/kg, Ketaset 25 mg plus propofol 25 mg, and saline placebo for pain control in mothers post-cesarean section in mothers post-cesarean section. A single dose was given immediately after clamping of the umbilical cord. The time to the first breastfeeding was 58 minutes in those who received placebo, 31.9 minutes with Ketaset and 25.8 minutes with propofol plus Ketaset. The time was significantly shorter than the other groups with the combination.[4]