Dissociative anesthesia for safety's sake: ketamine and diazepam--a 35-year personal experience

Plastic and Reconstructive Surgery
R A Ersek

Abstract

Recent discussions and proposed rules and regulations regarding outpatient surgery facilities have raised the question of the appropriateness of general anesthesia versus heavy sedation. The controversy is based mostly on anecdotal information and the prejudice of the authors. A recent article that describes the improved platelet function induced by ketamine adds patient safety to the rationale for sedation. Most of us have trained in university settings where an entire department was devoted to general anesthesia and little true outpatient surgery was performed. When ambulatory facilities were available, they were usually staffed by anesthesiologists. Indeed, the first free-standing outpatient surgery center in Phoenix, Arizona, was owned and operated by a local group of anesthesiologists. Properly administered, diazepam and ketamine dissociative sedation is safe and effective for every aesthetic procedure, regardless of size or duration, and it should be available for all aesthetic surgeons. In the author's experience, more than 30,000 procedures have been performed with this method since 1966 without a single case of deep vein thrombosis or pulmonary embolus. In contrast, a former associate, because of his lack of experience...Continue Reading

Citations

Jun 21, 2007·Aesthetic Plastic Surgery·Robert A Ersek
Aug 20, 2011·Aesthetic Plastic Surgery·Thomas NarseteRobert Ersek
Jul 10, 2013·Aesthetic Plastic Surgery·Peter ChangRobert A Ersek
May 1, 2007·Seminars in Plastic Surgery·Robert A Ersek
May 1, 2007·Seminars in Plastic Surgery·Robert G W Girling V, Mark Salisbury
Sep 11, 2010·Plastic and Reconstructive Surgery·Phillip C HaeckUNKNOWN ASPS Patient Safety Committee
Sep 11, 2010·Plastic and Reconstructive Surgery·Phillip C HaeckUNKNOWN ASPS Patient Safety Committee
Sep 6, 2015·Aesthetic Surgery Journal·Christopher J Pannucci, Adam Cuker
Apr 2, 2017·Aesthetic Surgery Journal·Eric Swanson, Ronald J Gordon
Jan 26, 2017·Plastic and Reconstructive Surgery·Christopher J Pannucci
Jan 8, 2008·Plastic and Reconstructive Surgery·Robert A Ersek
Aug 26, 2006·Plastic and Reconstructive Surgery·Mark A Clayman, Brent M Seagle
Dec 20, 2007·Plastic and Reconstructive Surgery·Robert A Ersek
Feb 28, 2008·Plastic and Reconstructive Surgery·Lorne Rosenfield
Jan 13, 2006·Plastic and Reconstructive Surgery·Fereydoun D ParsaAndrew Hsu
Jun 1, 2013·Plastic and Reconstructive Surgery. Global Open·Eric Swanson
Aug 3, 2016·Plastic and Reconstructive Surgery. Global Open·Eric Swanson
Oct 8, 2014·Plastic and Reconstructive Surgery. Global Open·Eric Swanson
Apr 24, 2009·Annals of Plastic Surgery·Mark A ClaymanRichard Sadove
Oct 5, 2010·Aesthetic Surgery Journal·John YangRobert A Ersek
Nov 9, 2017·Aesthetic Surgery Journal·Geoffrey R KeyesFoad Nahai
Jan 24, 2006·Clinics in Plastic Surgery·Robert G W GirlingRobert A Ersek
Dec 19, 2008·The American Journal of Emergency Medicine·Reuben J Strayer, Lewis S Nelson
Apr 9, 2008·Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists·Wei-Hung ChanTzuu-Huei Ueng

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