ANESTHESIA IN COSMETIC SURGERY

Abstract

Tired of hearing of evidenced-based medicine? Want to know how “I” do it? Then, Anesthesia in Cosmetic Surgery is for you. To our medical colleagues who are just recently discovering the art and science of the ambulatory anesthesia model, this is an interesting voyage into the belly of the beast. Dr Friedberg has long been a proponent and passionate advocate of the joys and the differences of the outpatient anesthesia experience to his medical colleagues, and this book provides the forum to expound on the insights he has gathered over the years.Dr Friedberg has been an innovator of the technique and concept he has coined “minimal invasive anesthesia” or “MIA.” Dr Friedberg contends that using a drug combination of propofol, ketamine, and clonidine combined with the use of bispectral index (BIS) monitoring makes outpatient anesthesia for cosmetic surgery simple, safe, and effective. Rather than being supported by peer-reviewed publications and studies, the author generally relies upon personal anecdotes and his extensive clinical experiences.What results is a “cookbook” on “how to do what I do” that has its inherent biases and limitations, but also sets the groundwork for validation of the technique, and makes one reexamine current techniques. On the other hand, there are excellent referenced, succinct, and readable chapters on regional anesthesia of the head and neck for plastic surgical procedures, preanesthetic assessment for the ambulatory patient, herbal supplements, and a very interesting discussion of the maximum doses of lidocaine. Any practitioner involved in sedation/anesthesia for outpatients would benefit from them.The author is very experienced in many of the nuances of an anesthesiologist's role in the ambulatory setting including fiscal, regulatory, and medico-legal aspects of this type of practice. These chapters are of great value for those anesthesia caregivers contemplating an office-based setting for their practices.I found this book a very interesting read for the dentist anesthesiologist and oral and maxillofacial surgeon who have been practicing this model for 140 years, but want to see what they have been doing validated, and see their practice through the eyes of another anesthesia provider. It certainly is an eye-opener to those whose sole anesthesia venue is the operating room.