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Increasing Safety in Anesthesia – Using a Brain Monitor

A special message from Amiya Prasad, M.D.:

I just returned from a conference in Charlotte, North Carolina run by Dr. Barry L. Friedberg. If you’ve been keeping up with the trial of Dr. Conrad Murray, who was the physician who administed Propofol to Michael Jackson, you would recognize Dr. Friedberg as being a vocal advocate for patient safety through proper monitoring. Having met Dr. Friedberg at a Cosmetic Surgery Conference (The Annual meeting of the American Academy of Cosmetic Surgery), I was very impressed by his knowledge in providing anesthesia in a safer way using a brain monitor. During surgery, we routinely monitor the heart rate, blood pressure, oxygen levels in the blood and the EKG (electrocardiogram). Ironically, it’s not been routine to monitor the brain which is the organ that the sedation is working on.  I incorporated the use of a brain monitor (also called a BIS Monitor), to monitor the level of sedation being given to our patients during surgery and have been absolutely delighted. Although this technology has been available for more than 10 years, very few operating facilities use BIS monitors. I’m very fortunate to have met Dr. Friedberg and my patients now benefit from his experience. To encourage people to advocate for themselves when it comes to proper and safe anesthesia during any surgery (not just Cosmetic), Dr. Friedberg created “The Goldilocks Foundation” [http://www.goldilocksanesthesiafoundation.org/] . Essentially it’s important in the modern era of health care for people to advocate for themselves. Dr. Friedberg advises to ask the questions “Do you use a brain monitor when I will be under anesthesia?”.

The practice of medicine requires a lifetime commitment to learning and flexibilty to provide the best care for our patients. Unfortunately, the practice of plastic surgery tends to be inflexible and focused on the use of general anesthesia which in my opinion is more for the surgeon’s convenience rather than the patient’s in many cases. As it has been my focus to perform natural aesthetic procedures which are safe, under local anesthesia with light sedation and with a quicker recovery, Dr. Friedberg’s contribution to my practice through his experience is truly appreciated.

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