Thai boys were drugged with ketamine for risky cave rescue

The 12 members of a Thai soccer team who were trapped in a cave last summer took ketamine before their dangerous rescue, according to an article published in a medical journal.

The 12 players, who ranged in age from 11-16, and their coach were trapped in a dark cave for about two weeks by a sudden flood. The whole world watched as they slowly made their way out in small groups in a rescue that involved lengthy and dangerous underwater dives over two days in July 2018.

And according to a letter published in the New England Journal of Medicine on Wednesday, the boys and their coach were anesthetized with ketamine for the rescue. They were also given full face masks that supplied 80 per cent oxygen and swum out of the cave by the rescue team.

Ketamine was chosen for a reason: while it’s useful as an anesthetic, it also constricts blood vessels, making it a “good choice for patients at risk for hypothermia,” according to the letter.

It’s also a fast-acting painkiller that can produce vivid dreams and a feeling that the mind is separated from the body, according to the Centre for Addiction and Mental Health. For this reason, it’s sometimes used recreationally — though it remains illegal outside of medical and veterinary settings.

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To get the boys out, rescue divers set up an underwater relay system of oxygen tanks and tethers and escorted them along. None of the boys had caving or diving experience.

Because the rescue involved long swims through cold water in “poorly fitting” wetsuits, hypothermia was a primary concern.

The field hospital which received the first four patients found that they had been anesthetized with “unspecified doses” of ketamine, administered by the rescue cave divers.

The medical team removed the full-face oxygen masks, replacing them with smaller masks. They gave the boys sunglasses to protect their eyes, which hadn’t seen sunlight in weeks, and carefully removed the wetsuits.

The doctors kept the boys warm after their long swim in cold water using cloth blankets, heated blankets, and foil wraps as well as other forced-air warming devices. Even their rehydration saline was warmed before they were transferred to the hospital.

One boy did develop hypothermia on the way to the hospital, according to the letter. After that, an anesthesiologist was assigned to take charge of hypothermia protection for the subsequent patients.

All 13 team members, including the coach, made it out of the cave alive. Only one person, a former Thai Navy SEAL, died during the rescue operation.

— With files from Josh Elliott

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