Expert: Use of Anesthesia Monitoring Technology Needs to Grow
Corona Del Mar -- An expert is encouraging his colleagues to adopt new technology that may allow anesthesiologists to more accurately administer dosages, which could help reduce vomiting after surgery.
"Here is something that can greatly improve a patient's overall postsurgical experience," says Barry Friedberg, MD, a leading anesthesiologist and clinical instructor in anesthesia at the University of Southern California, Los Angeles, in a news release. "We obviously don't want to undermedicate, but patients have indicated that they consider a fast and comfortable recovery to also be very important." The new technology, bispectral index (BIS), measures brain activity and consciousness during sedation. Although Friedberg agrees that the current practice of monitoring heart rate and blood pressure is essential, "BIS allows us to monitor the organ we are trying to sedate — the brain. Hand in hand, the two methods allow us to better gauge the patient's state of sleep and overall health. It makes sense to add it to the operating room."
The technology is currently being employed in 26% of hospital operating rooms in the U.S. Increased use of BIS could help reduce the incidence of under- or overanesthetizing patients and result in a decrease in vomiting and other anesthesia-related postsurgical adverse effects. Friedberg is concerned, however, that many hospitals and clinics might be putting the bottom line before patient care. "The relentless focus on the cost of healthcare is causing administrators to make some decisions at the expense of patients," he says. "The reality is that allowing anesthesiologists to do their job as well as possible will ultimately reduce costs. If we can make the anesthesia dosage more accurate, the patient will recover quicker, helping to eliminate unnecessarily lengthy or overnight stays."
According to Medscape Critical Care editor Alfred Saint Jacques, this technology is potentially useful for clinicians in intensive care units. "The research is just starting to get done," Saint Jacques says. "The jury is still out, but healthcare professionals need to know about the technology and decide on its utility for themselves." About 20 million patients undergo surgery with general anesthesia or deep sedation each year in the United States. Experts expect this number to have risen by the end of 2002 due to an increase in cosmetic surgeries following last September's tragedies. "Because people saw how uncertain life could be, they stopped putting off doing things for themselves, including elective beauty procedures," says Friedberg. "And that has lead to an increase in the number of people going under." Friedberg is the developer of the propofol ketamine (PK) technique designed to maximize patient safety by minimizing the degree to which patients need to be medicated. He was also the founder of the Society for Office Anesthesiologists (SOFA) in 1996, which later merged with the Society for Office Based Anesthesia (SOBA).