Propofol-ketamine (PK) anesthesia was originally described by Friedberg as dissociative monitored anesthesia care (MAC), which gives the patient the subjective experience of general anesthetic with few risks and virtually no postoperative nausea, vomiting, dysphoria, or hallucinations. Friedberg has a stellar 10-year record of safety with patients receiving propofol-ketamine anesthesia, with a 0.5% postoperative nausea and vomiting (PONV) rate. There were no hospitalizations in his group for either uncontrolled pain or PONV, the 2 most common reasons for admission following day surgery. For the surgeon who chooses to administer his or her own anesthesia, this paper describes a variation of Friedberg's original work. (See www.doctorfriedberg.com for other information.)
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References
1.
American Society of Anesthesiologists Task Force on Sedation and Analgesia by Non-Anesthesiologists. Practice guidelines for sedation and analgesia by non-anesthesiologists: An updated report. Anesthesiology. 93;5:1004–1017.
WatchaMFWhitePF, Postoperative nausea and vomiting. Its etiology, treatment, and prevention. Anesthesiology. 1992;77:162–184.
4.
CampbellLCWeisFRJr. Comparison of three techniques on time to awakening, time to orientation and incidence of nausea and vomiting using alfentanil in balanced anesthesia in an outpatient surgical setting. J Am Assoc Nurse Anesth.1990;58(3):241–247.
5.
KarpKB. Anesthetic recovery after ambulatory laparoscopy: A comparison of isoflurane and alfentanil infusion. J Am Assoc Nurse Anesth.1990;58(2):83–88.
6.
MadejTHSimpsonKH. Comparison of the use of domperidone, droperidol and metoclopramide in the prevention of nausea and vomiting following gynecological surgery in day cases. Br J Anaesth.1986;58: 879–883.
7.
PalazzoMGAStruninL. Anaesthesia and emesis. I: Etiology. Can Anaesth Soc J.1984;31(2):178–187.
8.
YoungMLKitzDSAndrewsRLeckyJHConahanTJ. Efficacy of antiemetic prophylaxis in patients receiving general anesthesia for outpatient surgery [abstract]. Anesthesiology.1988;69(3A):A449.
9.
VinnikCA. An intravenous disassociation technique of outpatient plastic surgery: Tranquility in the office surgical facility. Plast Reconstr Surg.1981;67: 199–205.
