Released on: November 27, 2007, 10:43 pm

Press Release Author: Barry L. Friedberg,

Industry: Healthcare

Press Release Summary: 'Goldilocks' anesthesia alludes to minimally invasive
anesthesia(MIA)® wherein patients are neither over-anesthetized nor
under-anesthetized but \'just right.\'


Press Release Body:


Corona del Mar, CA, November 27, 2007 -- 'Awake' the movie is a psychological
thriller that tells the story of a man who suffers \"anesthetic awareness\" and finds
himself awake and aware, but paralyzed, during heart surgery.

It has been 30 years since Robin Cook's 'Coma' captured and terrified the American
public's imagination. 'Coma' is the gripping story of patients who check into a
hospital for \"minor\" surgery-and never wake up again.'

"Five years after the book and movie, I still had patients extremely reluctant to
have surgery in Room 8, the site of Coma's (fictional) dastardly deeds," says Dr.
Friedberg.

In 1977, the anesthesia profession was 7 years away from technology that would have
obviated the premise of Coma; i.e. inflicting the lack of oxygen to produce the
vegetative state in patients so they could be harvested for organ transplants.

That monitor, the pulse oximeter, was introduced in 1984. Pulse oximetry was only
recognized by the American Society of Anesthesiologists (ASA) as a 'standard of
care' nearly a decade later.

"Primarily serving as a political organization, the ASA sometimes lags behind
reasonable clinical practice. After all, why wouldn't you want to know
instantaneously if your patient had adequate oxygen in their blood?" queries
Friedberg.

In 2007, 'Awake' the movie may, again, needlessly terrify the American public. This
time the technology that would have obviated the premise of the movie has been
available since 1996, when the FDA approved its use. "Again," asks Friedberg, "why
wouldn't you want to know how asleep your patient is?"

No technology is perfect, even level of consciousness monitors. The prototype is the
bispectral (BIS) index monitor. Published scientific study (2004) showed it was 82%
less likely for patients to remain awake when their anesthesiologist believed they
were asleep.

Why, then, have considerable numbers of anesthesia providers been reluctant to adopt
BIS monitoring?

\"Because measuring the brain\'s response to anesthetics challenges the deeply held
belief system that heart rate and blood pressure are reliable guides to depth of
anesthesia,\" opines Dr. Friedberg (N.B. Heart rate and blood pressure are unreliable
guides.)

In the well-known fairy tale, Goldilocks finds Poppa bear\'s porridge too hot, Mama
bear\'s porridge too cold, but Baby bear\'s porridge just right. 'Goldilocks'
anesthesia alludes to minimally invasive anesthesia(MIA)® wherein patients are
neither over-anesthetized nor under-anesthetized but \'just right!\'

BIS has a scale of 0-100. Awake is BIS 98-100. Recall rarely occurs at BIS below 75.
MIA falls between BIS 60-75. General anesthesia (the sleep portion) falls between
BIS 45-60. Overdosed is BIS less than 45.

Unfortunately for the patient, anesthesia at BIS below 45 is remarkably commonplace.

The consequences of overdosing may be just as sinister as under-dosing.

It is not uncommon for relatives of elderly patients to observe that, in layman\'s
terms, they are \'not quite the same\' after their anesthesia as they were before
surgery. This phenomenon is formally known as postoperative cognitive dysfunction
(POCD).

\"Many believe POCD may also be a function of anesthetic overdose,\" states Friedberg.

"Given its history with pulse oximetry, the public should not rely of the ASA to
insist that BIS monitoring be a standard of care," asserts Friedberg, a long time
ASA non-member.

"The greatest good that could come from 'Awake' the movie would be a groundswell of
public opinion demanding routine BIS monitoring for general anesthesia," states
Friedberg who routinely monitors his patients with BIS and believes it to be the
'standard of care.'
Press release distribution by PressReleasePoint(http://www.pressreleasepoint.com/)

Disclaimer: Dr. Friedberg is not employed by Aspect Medical Systems, makers of the
BIS monitor. He is not a stockholder or a paid consultant. The opinions expressed
herein are his professional opinion based on 10 years experience with BIS
monitoring.

More information can be found at www.cosmeticsurgeryanesthesia.com, a
patient-oriented, non-commercial web site.



Contact Information


Barry L. Friedberg,
Cosmetic Surgery Anesthesia
Corona del Mar, CA
USA
1-949-233-8845
drfriedberg@drfriedberg.com
www.drfriedberg.com






Web Site: http://www.drfriedberg.com

Contact Details: Barry L. Friedberg,
Cosmetic Surgery Anesthesia
Corona del Mar, CA
USA
1-949-233-8845
drfriedberg@drfriedberg.com
www.drfriedberg.com