Opioid abuse: Connecting the dots…

Very laudable that the POTUS has decided the current opioid epidemic is a national crisis. POTUS failed to place blame for how anesthesia given.

“Over 75% of opioid or heroin deaths begin with prescription pain killers,” said Cleveland Clinic CEO, Dr. Tobey Cosgrove.

Q: When do people most often receive prescription pain killers?

A: After surgery.

The surgeon’s skin incision is the critical moment for patients’ postoperative need for pain relief. Incision alerts patients’ brains their bodies have been ‘invaded.’ Neither general nor regional anesthesia block this extremely potent, negative signal.

Attempted at preemptive anesthesia with local anesthesia prior to injection under anesthesia still fails to block the ‘invasion’ signal from the patients’ brains. Postoperative pain along with postoperative opioid prescriptions remained the norm.

Pain and the awareness of consciousness are processed at higher brain levels. Heart rate & blood pressure changes are well known to be unreliable guides to higher brain level responses.

The 1996 FDA approved bispectral (BIS) index brain monitor provides a numerically reproducible guide to higher cortical responses. Numerical reproducibility is the foundation of all scientific medical practice.

As a board-certified anesthesiologist and early BIS adopter, I’ve been providing opioid free, brain monitored propofol ketamine (aka Goldilocks) anesthesia with local analgesia for the past 20 years for outpatient surgery for a wide variety of painful surgical procedures.

None of the more than 4,000 patients I anesthetized over the past 20 years were admitted to the hospital for pain management. Few took opioids for postoperative pain. None became addicted to opioids.

Download a free, no obligation copy of my public education book, ‘Getting Over Going Under, 5 things you MUST know before anesthesia from my 501c3, nonprofit Goldilocks Foundation.

Disclaimer: Neither Dr. Friedberg, nor his nonprofit Goldilocks Anesthesia Foundation, receive financial support from BIS makers.