Today is the 19th anniversary of my first propofol ketamine anesthetic that was given at a Newport Beach plastic surgeon’s office!
Propofol ketamine is the ‘lemonade’ I made from Martha’s ‘lemon’ or avoidable demise.
Had it not been for this plastic surgeon’s refusing to allow me to use narcotics or smelly gases, I would have never been motivated to find an alternative anesthetic paradigm.
Little did I know, 19 years ago, how dramatically for the better that motivation would change the lives of my patients as well as my professional life.
Louis Pasteur said, ‘Luck favors only the prepared mind.’
So when I heard Charles Vinnik talk about Valium-ketamine anesthesia @ the Hyatt Newporter in December 1991, I was ‘prepared’ to seek an alternative.
My first insight was finding that sleep doses of propofol blocked ketamine hallucinations every bit as well as Vinnik’s Valium.
Later, once I saw that giving 50 mg ketamine (aka the ‘nifty fifty’) before injecting the patient would prevent surgeons from inflicting pain on their unconscious, helpless patients, it became a matter of conscience to no longer give narcotics or smelly gases for cosmetic surgery.
Incorporating the brain monitor in December 1997 allowed others to reproducibly create my paradigm as well as giving every patient a custom tailored experience as opposed to ‘one size fits most’ anesthesia.
However, it was not until I experienced the absence of pain for 4 days after my own total hip replacement in May 2008 that I realized the ‘nifty fifty’ was applicable to any time the skin is breached for surgery.
While writing ‘Getting Over Going Under’ to help the general public deal with anesthesia fears, Michael Jackson died from unsafe propofol administration. I knew that I needed to add comment about his avoidable death to my book.
Brain monitoring would have enabled Conrad Murray to tell the difference between the benzodiazepine and propofol effect in Michael Jackson’s body. Jackson would still be alive today had this monitoring been used on him.
Brain monitoring is the 21st century standard for anesthesia care & propofol ketamine is the safest anesthetic.