What is your evidence for using BIS values to prevent post anesthesia dementia?

August 20, 2010 8:10:42 AM PDT

Dr. Friedberg,

I have been on your email list for a couple of years and am a new anesthesiologist practicing at a level 1 trauma center here in Utah. I understand the difficulty of trying to change the established medical dogma. I was wondering what evidence are you using to make the claim that lower BIS values (as a surrogate marker for "anesthesia overmedication") or for that matter a change in anesthetic technique including regional or neuraxial anesthesia lead to differences in POCD and other peri-operative neuropsychiatric impairments?

Expert Anesthesiologist Thinks Michael Jackson’s Physician, Dr. Conrad Murray Will Go to Jail


Albeit in a non-surgical setting, nevertheless the LA coroner ruled that Michael Jackson died from a propofol anesthetic overdose.

The message of the newly published 'Getting Over Going Under' book is to educate the general public of the need to demand a brain monitor when going under anesthesia precisely to avoid anesthetic overmedication - a routine, yet nefarious 20th century practice prior to the introduction of a simple device to directly measure patient's brain response to anesthetic drugs.

If convicted, Murray only faces a maximum of

Preventing Post-op Delirium in May 2010 Outpatient Surgery Magazine

This month's Outpatient Surgery Magazine features a neat little article on how to prevent post-op delilrium.

Anesthesiologist Warns of Fatal Dangers Of Going Under What EVERY Patient Should Know Before Surgery

The National Health Federation

Anesthesiologist Warns of Fatal Dangers Of Going Under
What EVERY Patient Should Know Before Surgery

By Dr. Barry Friedberg
April 22, 2010

even paranoids have enemies: The ‘Establishment’ Strikes Back at Goldilocks anesthesia

The ‘Establishment’ Strikes Back at Goldilocks anesthesia

Two years following publication of the groundbreaking textbook, Anesthesia in Cosmetic Surgery, 'the establishment' countered with Patient Safety in Plastic Surgery.

‘The establishment’ refers to the organized societies for plastic surgery and anesthesia - the American Society for Aesthetic Plastic Surgery (ASAPS), the American Society for Plastic Surgery (ASPS), and the American Society of Anesthesiologists (ASA).

Is academic freedom only for academics?

Yesterday, I had a few email exchanges with Dr. Harvey Rosenbaum, director of anesthesia resident education @ UCLA. I told him I was planning to attend Anesthesia Grand Rounds this coming Wednesday because the topic, Delirium: risk factors, potential mechanisms, prevention and treatment, was of great interest to me.

Without any admonition from Dr. Rosenbaum (or anyone else in his department), at 09:40 April 5, 2010, I received the following communication from the Director of Security Services @ UCLA:

Numbers that might be of interest

Google search for 'American Society of Anesthesiologists' yields 595,000 sites

Google search for 'Barry Friedberg MD' yields                              798,000 sites

Google search for 'Cosmetic Surgery Anesthesia' yields            2,200,000 sites

     www.drfriedberg.com is the #1 unsponsored site

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