**Brain Monitored Propofol Ketamine for Elective Cosmetic Surgery Cosmetic Surgery**

**Brain Monitored Propofol Ketamine for Elective** 

DOI: 10.5772/intechopen.71442

Barry L. Friedberg Barry L. Friedberg Additional information is available at the end of the chapter

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/intechopen.71442

#### **Abstract**

Brain monitored level of propofol hypnosis provides a numerically reproducible paradigm to block negative ketamine side effects. 50 mg IV ketamine 3 minutes prior to local anesthetic injection blocks virtually all midbrain NMDA receptors and is the basis for nonopioid preemptive analgesia. Opioid avoidance essentially eliminates postoperative nausea and vomiting (PONV) as well as the need for antiemetic agents. Over the past 20 years, no elective cosmetic surgical cases required hospital admission for either postoperative pain control or PONV.

**Keywords:** brain monitoring, BIS/EMG, propofol, ketamine, nonopioid preemptive analgesia (NOPA), PONV
