Navigation Links
'Awake' the Movie Highlights the Need for 'Goldilocks' Anesthesia, Says Dr. Barry L. Friedberg, Developer of Bispectral Index (BIS) Monitored Propofol Ketamine Sedation, Now Trademarked as Minimally Invasive Anesthesia (MIA)(R)

CORONA DEL MAR, Calif., Nov. 27 /PRNewswire/ -- '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. A 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)(R) 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 on 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.'

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, a patient-oriented, non-commercial web site.

SOURCE Cosmetic Surgery Anesthesia
Copyright©2007 PR Newswire.
All rights reserved

Related medicine news :

1. Audiences Nationwide Will Awake to a Frightening Reality on November 30th
2. Teens who see more smoking in movies may have increased risk of becoming established smokers
3. Smoking in Movies May Put Teens at Risk
4. Ricki Lakes New Movie, The Business of Being Born Promoted by Local Mom-Roots Campaign
5. R rating might be unlikely to affect teens exposure to smoking in movies
6. Increasing young adult smoking linked to smoking in movies
7. On-screen smoking in movies linked to young adult smoking behavior
8. Actor Joe Pantoliano Discloses Depression; Talks About His Latest Movie and His Sensitive Side
9. Stanford study highlights cost-effective method of lowering heart disease risks
10. REACH Registry Highlights That Patients With Peripheral Arterial Disease (PAD) Suffer High Rates of Heart Attack, Stroke, Hospitalization, and Death
11. Other highlights in the September 11 JNCI
Post Your Comments:
(Date:11/30/2015)... MN (PRWEB) , ... December 01, 2015 , ... ... is the latest carrier to offer individual vision insurance plans on ... the unique ability to rate and review products, allowing consumers to compare, quote ...
(Date:11/30/2015)... ... 2015 , ... During the National Family Caregivers Month, the ... webinars on topics of ‘Medical and Palliative Care Decisions,’ and ‘Self-Care for Caregivers.’ ... , With a loved one's diagnosis of mesothelioma, the closest family member is ...
(Date:11/30/2015)... (PRWEB) , ... November 30, 2015 , ... ... surgery and dermatology, is proud to announce that its ThermiRFR temperature controlled radiofrequency ... ThermiRF is an innovative multi-application radiofrequency platform which uses temperature as a clinical ...
(Date:11/30/2015)... ... November 30, 2015 , ... The ... this summer, ushering in a new era of publicly accessible automated technology. Now, ... will continue to offer guests an up-close look at the shuttle at MOSI’s ...
(Date:11/30/2015)... ... 30, 2015 , ... On Saturday, October 24th, 2015, at the Mill Race ... event, a 5K walk known as “Making Strides Against Breast Cancer”. Patients and staff ... also located in Battle Creek, joined in for this campaign that sought to raise ...
Breaking Medicine News(10 mins):
(Date:11/30/2015)... Calif. , Nov. 30, 2015 /PRNewswire/ ... today that Matt Hogan , Chief ... Oppenheimer Healthcare Conference on Tuesday, December 8 ... is being held at the Westin Grand ... also be available for one-on-one meetings at ...
(Date:11/30/2015)... , Nov. 30, 2015 Next week, December ... of Things (DoT ) co-located events covering the latest ... Internet of Things, will draw more than 3,000 design ... Convention Center. The events, combined show floor will ... --> --> ...
(Date:11/30/2015)... Nautilus Medical Inc. today announced worldwide availability of MatrixRay, ... The release of MatrixRay to the entire medical healthcare ... America) in Chicago - the ... --> --> MatrixRay is the first ... worldwide via a peer-to-peer exchange network of physicians and ...
Breaking Medicine Technology: