Abstract. 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. There were no hospital admissions for postoperative nausea and vomiting (PONV) or uncontrolled pain. 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).

Case reports are presented demonstrating a new, safe, and simple intravenous technique for outpatient anesthesia. Vinnik's technique requires hypnotic doses of diazepam (Valium) to prevent ketamine-induced hallucinations. The initial hypothesis tested in this clinical series was whether hypnotic doses of propofol would prevent hallucinations from ketamine as satisfactorily as diazepam. Once the initial hypothesis was confirmed, consideration was given to moderating the cost of propofol by determining the effect of two levels of midazolam premedication on propofol requirements. Hypnotic doses of propofol do prevent ketamine-induced hallucinations. It is possible to achieve significant propofol savings by premedication with midazolam without compromising patient readiness for discharge by the end of the first postoperative hour.

Study Objective: To compare the effect of a standardized stimulus during propofol-only hypnosis on the bispectral index (BIS) value with the effect of the injection of local anesthesia for surgery during ketamine plus propofol hypnosis (dissociative monitored anesthesia care). To determine whether ketamine increases the level of propofol hypnosis

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