Office-Based Anesthesia: Author's Response to Commentary

Abstract

TO THE EDITOR Dr. Halperin's commentary1 on my article2 (“Office-Based Anesthesia: Dispelling Common Myths,” published in the September/October 2008 issue of the Journal ) expands the controversy surrounding anesthesia care for complex surgery in the office setting. The anesthesia technique used at the facility at which I practice developed out of the need to provide adequate anesthesia/sedation for complex, sometimes lengthy, cosmetic surgeries without resorting to conventional general anesthesia. Therefore, we excluded invasive airway devices, paralysis, and vapors or gases. The infusion of propofol-ketamine (PK) to produce deep sedation while maintaining spontaneous ventilation, simple devices to supplement oxygenation, and multiple intercostal nerve blocks (ICNB) to produce truncal anesthesia quickly demonstrated to anesthesiologists and surgeons that these modalities were able to provide anesthesia safely. I was invited by Aesthetic Surgery Journal to submit an article specifically on the topic of PK in aesthetic surgery, which was felt to be of interest …