Vinnik C A
Plast Reconstr Surg. 1981 Jun;67(6):799-805. doi: 10.1097/00006534-198106000-00016.
Intravenous diazepam and ketamine may be used as sole agents, along with local anesthesia, or in combination with preoperative sedation in office plastic surgical procedures. These medications can lower or, in some instances, eliminate the requirements for local anesthesia. They enable procedures traditionally confined to hospital operating rooms (where general anesthesia must be used) to be done in office surgical facilities. True dissociation occurs, and this is not seen without the use of ketamine, which selectively and centrally blocks the effect of painful stimuli without obtunding vital functions. Use of these two agents together is mandatory, because of the use of ketamine alone can produce unwanted side effects. Together, diazepam and ketamine exhibit synergism, with the adverse effects of each being canceled by the other. This dissociative technique appears to approach the "ideal" in a properly staffed and equipped office surgical facility with appropriate patient selection. Tranquility can now be a reality for the patient, staff, and plastic surgeon.
静脉注射地西泮和氯胺酮可单独使用，或与局部麻醉一起使用，也可在门诊整形手术中与术前镇静联合使用。这些药物可以降低或在某些情况下消除对局部麻醉的需求。它们使传统上局限于医院手术室（必须使用全身麻醉）进行的手术能够在门诊手术设施中完成。真正的解离状态会出现，而不使用氯胺酮则不会出现这种情况，氯胺酮能选择性地、在中枢阻断疼痛刺激的作用而不抑制重要功能。必须将这两种药物一起使用，因为单独使用氯胺酮会产生不良副作用。地西泮和氯胺酮一起使用表现出协同作用，彼此的不良反应相互抵消。在人员配备和设备完善、患者选择合适的门诊手术设施中，这种解离技术似乎接近“理想状态”。现在，患者、工作人员和整形外科医生都能实现平静的状态。
