Preventing NegativePressure Pulmonary Edema in He

Authors: Ersek Robert A

Publish Date: 2004/01/01

Volume: 24, Issue: 1, Pages: 49-49

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Abstract

I am writing in reference to the article by Drs Dieu and Upjohn and the Commentary by Dr Matchett concerning “NegativePressure Pulmonary Edema in Healthy Cosmetic Surgery Patients” 200323270273 The cases described have in common the use of intubation and general anesthesia Dr Matchett said in his Commentary that the incidence of negativepressure pulmonary edema NPPE is 1 or 2 per 2000 casesThese cases illustrate the advisability of treating healthy elective cosmetic surgery patients with Valium and ketamine dissociative anesthesia which allows the reflexes to remain intact All of the complications of narcotics respiratory depressants and intubation are thus eliminated1–4 We have had more than 30000 plastic surgery cases in our practice since 1966 without a single case of NPPE According to the statistics cited above we should have seen 30 to 60 such cases In addition a recent article has shown that administration of ketamine both decreases platelet adhesiveness and helps maintain muscle tone in the legs5 These benefits are clear in our own practice We encountered neither deepvein thrombosis nor pulmonary embolism in any of our 30000 cases Drs Charles A Vinnik and Thomas Baker have informed me personal communication letter May 2003 that they have never seen an instance of deepvein thrombosis or pulmonary embolism in patients treated only with Valium and ketamine dissociative anesthesia in their own even more extensive series of cases

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