Articles: surgery.
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Aesthetic plastic surgery · Jan 1999
Propofol-ketamine technique: dissociative anesthesia for office surgery (a 5-year review of 1264 cases).
Propofol-ketamine technique is a room air, spontaneous ventilation (RASV), intravenous dissociative anesthetic technique which simulates the operating conditions of general anesthesia without the increased equipment requirements or costs. A total of 2059 procedures were performed on 1264 patients by 38 different surgeons. ⋯ All patients were pleased with their anesthetic and no hallucinations were reported. Cost:benefit analysis is presented as well as discussion of dissociative anesthesia being exempt from current California law (AB595).
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The moratorium in the USA on inserting breast implants filled with silicone gel caused global alarm by inaccurate media reports resulting from settlements and verdicts against the manufacturers. In fact, there still is no scientific evidence that the implants have negative effects on health. ⋯ In the Netherlands it has been obligatory since June 1998 for all medical implants to carry a quality mark. In addition, it is the intention that data on silicone breast implants will be recorded in a national registration.
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Health care delivery is undergoing a revolutionary change. It is focusing rapidly all over the world towards outpatient and home care. One of the most obvious results of these changes has been the relative explosion office-based surgery and anesthesia; however, these are not new concepts. ⋯ These guidelines should be based on the specific type of surgery, the level of anesthetic required and the design of the office. This way the provision of adequate quality of care is ensured. Office-based anesthesia and surgery will no doubt continue to evolve because it is safe, pleasing and convenient for the patient and of low cost.
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This case illustrates the usefulness of an endovascular stent to treat a pseudoaneurysm of the cervical internal carotid artery. A 46-year-old male patient presented with a spontaneous dissection of the cervical internal carotid artery. ⋯ The patient sustained no neurological complications and the stenosis of treated carotid artery did not occur during the 6-month follow-up period. For internal carotid artery dissection, stent placement seems to be a reasonable therapeutic alternative to direct surgery.