|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 and compassionate clinical expertise,
which exceeds patients' expectations. Dr. Friedberg is dedicated to providing
highly evolved anesthesia with optimum results.
Anesthesia For Outpatient Surgery
I am planning on having an elective cosmetic plastic surgery procedure next
month in my surgeon's office. My surgeon spent a great deal of time explaining
the procedure, but really didn't tell me anything about my anesthesia options.
What is anesthesia and what are my options?
Oliver Wendell Holmes coined the term "anesthesia" in the mid-1800's to describe
the state of etherisation as the absence of sensation. We know that the state
of anesthesia is composed of the elements of hypnosis (sleep) and analgesia
You should know that in an office-based setting, you might receive your anesthesia
from the surgeon's secretary (at the surgeon's direction), a registered nurse
with technical training in anesthesia, or an anesthesiologist (an MD specializing
in the medical practice of anesthesia). You should find out who will be administering
your anesthesia before undergoing your procedure.
In addition, you should know that office-based anesthesia has given rise to
the demand for short-acting, fast emerging anesthesia. You may ask if they will
offer this to you. This type of anesthesia helps the patient recover quickly,
hopefully 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 Barry Friedberg,
MD and is 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 being awake. This is important because
when you have less anesthesia, your risk for "PONV"--post-operative nausea and
vomiting--is tremendously reduced. This is one of the most common side effects
of surgery, and one that you can avoid with the PK Technique.
Be sure to balance the advantages, and make sure that the facility where you
will have your procedure 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
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 an absence
of inhalational 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 present, as well as polices and procedures to handle the
day-to-day activities as well as emergencies.
For more information,
check out www.doctorfriedberg.com,
or email Dr. Friedberg at email@example.com.
Created: 11/14/2001  - Barry L. Friedberg, MD