doctorfriedberg.com Anesthesia Site 10 "Must Ask" Questions Prior to Surgery

Date Published: 
Wed, 2002-06-12



Corona del Mar, CA, June 11, 2002 ---- Barry L. Friedberg, M.D., nationally recognized for his innovative cosmetic anesthesia techniques, has noticed a dramatic shift in web site educated patients.

Says Dr. Friedberg, "More than 60 percent of my patients in the last 12 months, versus one-year prior, have clearly done their homework on knowing and understanding their anesthesia options." He adds, "For the world of health care where web based education is being imagined and provided at cyber-speed, this is a great message that resonates throughout the health care landscape -- clearly patients are taking advantage of the research and learning capabilities offered by the web." Dr. Friedberg's cosmetic surgery anesthesia web site www.doctorfriedberg.com is consumer-driven and provides a solid overview in an easy to understand format for patients. The site has logged more than 10,000 visitors in just eight months. Says Nicanor Isse, MD, a prominent cosmetic surgeon in Southern California, "Since the launch of www.doctorfriedberg.com last year, the web site has proven to be a real boost to assisting patients with what can be one of the most frightening components of surgery -- anesthesia. My patients have embraced the information available on the site as easy to understand, and extremely helpful at demystifying anesthesia administration."

Oliver Wendell Holmes first coined the term "anesthesia" in the mid-1800s to describe the state of etherisation as the absence of sensation. The state of anesthesia is composed of the elements of hypnosis (sleep) and analgesia (pain relief).

Many cosmetic surgery procedures are performed in an office-based setting. Here patients might receive anesthesia from the surgeon's secretary (at the surgeon's direction), a registered nurse with technical training in anesthesia, or an anesthesiologist (a physician specializing in the medical practice of anesthesia). This is the singularly most important first question to ask.

In addition, office-based anesthesia has given rise to the demand for short-acting, fast emerging anesthesia. Patients should ask if this is available. Says Dr. Friedberg, "This type of anesthesia helps the patient recover quickly, usually pain and nausea free. One type of anesthesia that has become very popular is "PK." The "P" stands for propofol and the "K" stands for ketamine." The combination "PK" stands for an anesthesia technique pioneered by Dr. Friedberg 10 years ago, designed to maximize patient safety in the office-based setting.

PK technique creates the illusion of general anesthesia, with the minimal trespass of sedation. Patients neither hear nor feel their surgery, yet remain at the lightest level of anesthesia short of awake. This is important because when you have less anesthesia, your risk for post-operative nausea and vomiting (PONV), is tremendously reduced. This is one of the most common side effects of surgery, and one that you could eliminate with the PK Technique.

Dr. Friedberg urges patients to take care that the office-based surgical facility has the ability to handle common emergencies which may occur during your surgical procedure i.e. oxygen, Ambu bag and suction device to clear the airway - these are minimal standards insisted upon by medical liability carriers.

According to the American Society of Anesthesiologists' publication on guidelines for a safe office anesthesia practice, an anesthesia machine is not necessary when non-triggering anesthesia is used. Non-triggering agents refers to no inhalation agents like isoflurance, desflurance or sevoflurane. In fact states like California and Florida led the nation in requiring office certification by AAASF, AAAHC or HCFA agencies. Certification assures that a crash cart and defibrillators are presentation as well as polices and procedures to handle the day-to-day activities as well as emergencies.

If you are contemplating cosmetic plastic surgery, here's some question should ask your surgeon and anesthesiologist:

1) Who is giving my anesthesia? (An anesthesiologist (MD), CRNA, or surgeon)
2) Is this individual experienced in administering in an office-based setting?
3) What non-narcotic strategies will you be using for pain management to avoid the use of narcotics (morphine, Demerol, fentanyl, etc) which are associated with a high rate of postoperative nausea and vomiting (PONV)? Hint: preemptive analgesia
4) Will I get medicine to relax me before surgery
5) Will you be injecting local anesthesia prior to the surgery?
6) How will you be managing the pain from the local anesthesia injection?
9) Will you be using a long acting local anesthetic at the end of surgery at the surgical site
10) Is there a web site where I can get more information about anesthesia? www.doctorfriedberg.com.


Barry L. Friedberg, MD, a globally recognized leader in the field of Anesthesia, shares his vision for innovative elective office-based cosmetic surgery anesthesia for the discriminating patient. Dr. Friedberg provides personalized, compassionate, clinical expertise, which exceeds patients' expectations. Dr. Friedberg is dedicated t providing highly evolved anesthesia with optimum results. For more information, see www.doctorfriedberg.com or email him Dr. Friedberg at doctorfriedberg@doctorfriedberg.com.

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