Outpatient Surgery Magazine

Date Published: 
November 2002

The Trouble with PK

Barry Friedberg, MD, is taking PK prime time. The self-proclaimed King of Cosmetic Surgery Anesthesia was last seen giving away pens and Post-It notes from his booth at the American Society of Anesthesiologists Meeting. He has hired not one but two publicists to tell the world why his patients like their surgery but love their anesthesia, erected a shrine to his Propofol-Ketamine technique at doctorfriedberg.com and launched an on-site anesthesiology consulting business.

Yet it seems that the louder he shouts from the rooftops that outpatient surgery patients are "getting less-than-wonderful anesthesia when wonderful exists," the more his colleagues cover their ears. "I’m challenging a deeply held belief system, so I’ve taken a lot of guff," says Dr. Friedberg, tan and trim at 53. The response to PK thus far has been cold-shoulder cool, in large part because Dr. Friedberg’s colleagues are reacting more to his bombastic personality than to his proposition of gentler, kinder, opioid-free anesthesia that he claims virtually eliminates PONV.

"He’s amusing," says one prominent anesthesiologist. "He makes some good claims, but they’re not backed by controlled studies. Where is the evidence that PK works? Ask him if he’d use PK on a lap cholecystectomy." (No, he wouldn’t, but Dr. Friedberg says PK extends beyond cosmetic surgery to such cases as hernia repair, breast surgery and gyn laparoscopy.)

The PK technique (see "How to Administer PK" on page 5) is controversial — ketamine, after all, is a hallucinogenic street drug with a well-earned bad reputation — and Barry Friedberg is full of swagger and, some would say, himself. But before you dismiss the man and his method, hear this: In the 10 years that Dr. Friedberg has been using the PK technique in his office-based plastic surgery practice, he says only 13 of 2,680 patients (0.5%) have experienced PONV. Plus, he says his patients come to quickly, almost refreshed — not wrung out, hung over or in pain.

"How difficult do you want to make simple cases?" he asks. "PK is minimal trespass. It’s Anesthesia Lite."

Website Development by Regency Web Service

Web Development by Nicholas Alipaz, in conjuction with Regency Web Service