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The Top Cosmetic Gynecologists

Wisdom, rants and raves from the best, about the best, and about the rest.

Hosted by Dr. Marco Pelosi III

Nov 21, 2019

Barry Friedberg is a Stanford-trained anesthesiologist who pioneered Propofol-Ketamine sedation anesthesia.

He added brain monitoring to his method and the rest is history.

His rates of postoperative nausea and vomiting are the lowest in the world.

He hasn't used opioids for surgery in over 30 years.

Dr Pelosi III sat down with this innovative pioneer to learn the story behind the method.



Friedberg’s Triad [4:15]

is brain, pain, abstain


Goldilocks [5:40]

is the analogy that requires explanation.


The EMG [7:00]

looks forward.


Propofol [8:00]

use is reduced 30 percent.


Ketamine [10:20] was a hard sell.


Benzodiazepenes [10:55]

are not well measured by BIS


BIS [12:00]

is low maintenance


Cooperation [14:00]

of the surgeon is essential.


The myths [16:15]

surrounding ketamine.


Awareness [19:30]

under general is rare, but real.


Brain fog [21:00]

can be permanent rarely.


My free book [22:40]

is available via the Goldilocks website.


My superfans [24:00]

include Jan Paul Mulier from Brugge, Belgium.


50 consecutive patients [26:30]

given opioid-free anesthesia had no nausea and required no opioids afterwards.


A publisher [29:50]

asked me to write a textbook on cosmetic surgery anesthesia.


The military [30:20]

uses my techniques.


People [32:00]

resist change.


Not a single patient [35:25]

in over 6000 cases was hospitalized for nausea and vomiting.


My wife and I [37:00]

have both gone under this type of anesthesia.


Drug shortages [42:30]

might require substitution.


Abstain [44:30]

to address the Big Little Problem.


Only 0.6% [46.30]

of over 1200 patients had postoperative nausea and vomiting in my 1999 article.


Cosmetic practices [48:30]

don’t want to be embarrassed.


The standard rates [49:50]

of postoperative nausea and vomiting at the time were 10 to 40%.


How [51:40]

do you break the ice?


Dr. Barry Friedberg can be found online at the following links: