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American Society of Anesthesiologists (ASA) - Myths About 'Never Ending Pursuit of Patient Safety and Satisfaction' Debunked
Date:3/11/2009

PK anesthesia denied Level I validation for Postoperative Nausea and Vomiting (PONV)

CORONA DEL MAR, Calif., March 11 /PRNewswire/ -- Pulse oximeters became available in 1983, making each patient's oxygen status known on a beat-by-beat basis. Not until 1990, did the American Society of Anesthesiologists (ASA) say that all patients should have this monitor. No articles on this critical safety subject appear in the ASA Newsletter on their web site between 1983 and 1990.

Action: In 1983, Dr. Barry Friedberg insisted his hospital administrator purchase pulse oximeters for every anesthesia location in his southern California hospital. Friedberg had no financial interest in the oximeter company.

The first of the new of brain activity monitors was FDA approved in 1996. Prior to this monitor, anesthesiologists were forced to give more anesthesia than necessary for fear of giving too little. With this monitor, anesthesiologists can avoid this practice and give only that amount which is necessary.

Action: In 1997, Friedberg was the first Orange County anesthesiologist to begin routinely monitoring his patients with a brain activity monitor. Again, Friedberg had no financial interest the brain monitor company.

As recently as 2006, evidence that the over-medicating style of practice elevated inflammatory markers and was associated with postoperative cognitive dysfunction (POCD). Numbers-wise, POCD is a far bigger potential public health problem than that of anesthesia awareness. Yet, only primarily because of the potential public reaction to 'Awake' the movie, did the ASA move to create www.awaredb.org.

Action: Missed the 'forest' for the 'trees.'

A 1999 scientifically validated, Stanford university study showed patient satisfaction was highest when postoperative vomiting did not happen.

Propofol ketamine (PK) anesthesia was developed in 1992 by Friedberg. PK was enhanced by the addition of a brain activity monitor in 1997. In 1999, the lowest PONV rate of 0.5% was published in a high-risk group of patients without the use of any anti-vomiting drugs. With 43,000 members, the ASA web site has no patient testimonial page.

Action: One doctor - http://www.doctorfriedberg.com/testimonials3.htm

In 2004, a Level I study was designed by one of the foremost internationally recognized names in postoperative nausea and vomiting (PONV). When presented with the means (and funding) to validate PK anesthesia as a way to provide the 'never ending pursuit of patient ...satisfaction' by eliminating PONV, seven different universities (all ASA affiliates) declined the opportunity.

Let the public decide.

Do actions speak louder than words?

For more information about PK anesthesia: www.drfriedberg.com


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SOURCE Dr. Barry Friedberg
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