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Minimally Invasive Anesthesia (MIA)™ for Minimally Invasive Surgery
[Download This Article]
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| Barry L. Friedberg, MD |
| As facility managers and anesthesia providers move beyond the rhetoric and search for real answers to eliminating post-operative nausea and vomiting (PONV)
and pain, growing numbers have moved to a minimally invasive anesthetic (MIA)™ approach for minimally invasive procedures. Rather than using benzodiazepines, muscle relaxants, inhalational agents
and opioids, an MIA™ approach takes advantage of the surgeon’s use of local anesthesia for the analgesia portion of the hypnosis + analgesia = anesthesia equation. |
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10 Tips For Fast Tracking Outpatients. [View This Article]
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| Barry L. Friedberg, MD |
| Patients feel no pain, yet they respond to the surgeon's commands. And After that, they don't remember a thing. Welcome to the world of conscious sedation. Here are 10 pearls to fine-tune your regimen. |
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What is 'general anesthesia'? [View This Article]
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| Barry L. Friedberg, MD |
| Regarding Dr. Wheeland's editorial ("Office-based cosmetic surgery: How can it be proven safe?" Cosmetic Surgery Times Jan/Feb), I am inclined to support Dr. Wheeland's
conclusion that general anesthesia (GA) should probably be restricted from use in the office-based practice of cosmetic surgery. My concern is with the undefined use of the term 'general anesthesia'
— which may have some unforeseen consequences inimical to patient safety in the office-based setting for cosmetic surgery. |
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California Society of Anesthesiologists: Anesthesia without Violence, Propofol Ketamine Anesthesia [Download
This Article]
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| Barry L. Friedberg, MD |
| There are no emergency facelifts in my practice. Ironically, the office based anesthesiologist, while dealing with a truly elective patient population, is actually
held to a higher standard of care than his institutional based counterpart. |
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The Effect Of A Dissociative Dose Of Ketamine On The Bispectral Index (BIS®) During Propofol Hypnosis [Download
This Article]
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| Barry L. Friedberg, MD |
| 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 when used in dissociative
doses. |
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Propofol-Ketamine Technique: Dissociative Anesthesia for Office Surgery
(A 5-Year Review of 1264 Cases) [Download This Article]
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| Barry L. Friedberg, MD |
| 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). |
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Bispectral Index® (BIS®) Monitoring Decreases Propofol Usage in Propofol-Ketamine Office-Based Anesthesia [Download
This Abstract]
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Barry L. Friedberg, MD and Jeffrey C. Sigl, PhD
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| BIS® monitoring has been demonstrated to reduce propofol usage in propofol/alfentanil/N2O technique. The current study investigated the effect of the implementation
of routine BIS® monitoring on propofol consumption during office-based propofol-ketamine anesthesia. |
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Clonidine Premedication Decreases Propofol Consumption During Bispectral Index® (BIS®) Monitored Propofol-Ketamine Technique for Office-based Surgery
[Download This Article]
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Barry L. Friedberg, MD and Jeffrey C. Sigl, PhD
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Propofol-ketamine anesthesia is a room air, spontaneous ventilation (RASV), dissociative intravenous (IV) sedation technique reported to have a near-zero postoperative
nausea and vomiting (PONV) rate. Clonidine premedication has been reported to control blood pressure intra- and postoperatively, as well as to reduce the requirements for hypnotic agents. The
Bispectral Index® (BIS®) monitor is a reproducible, objective, observer independence, quantitative measurement of the hypnotic state.
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| Facial Laser Resurfacing with the Propofol-Ketamine Technique: Room Air, Spontaneous Ventilation (RASV) Anesthesia [Download
This Article] |
Barry L. Friedberg, MD
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| Multiple anesthetic approaches exist for full face laser resurfacing. The propofol- ketamine technique is reviewed as a reasonable alternative to providing
adequate anesthesia for full face laser resurfacing in the office environment. |
