inner-ear surgery or an
eye-muscle surgery, or
pretty much any kind
of plastic surgery —
all of these will
expose the patient to a
higher PONV risk.
3
Avoid
volatile
anesthetics.
Unless someone who
has a personal history
of nausea and vomit-
ing tells you upfront,
"Yes, I'm going to have
a problem," there's no
tried-and-true way to
predict when PONV
will be an issue. But
using volatile anes-
thetics, including
nitrous oxide, is sure
to ratchet up the risk.
So when and if you
can avoid volatile
anesthetics, ask yourself: What is a safe alternative? Whenever possi-
ble, I'd suggest using a propofol infusion in their place. Other consid-
erations: Is regional anesthesia or neuroaxial anesthesia an option,
given the nature of the procedure? Also, using opioids to manage a
4 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 1 7
Chances are you've
seen anesthesiologist
Edna Ma's face
before. She was one
of 18 castaways com-
peting for the $1 mil-
lion purse on CBS's
long-running reality
show Survivor: South
Pacific. She spent 33
days on the island of
Upolu, Samoa, and
outlasted all but 6 of
her fellow castaways. Two years later,
she appeared on ABC's Shark Tank. There
she promoted Dr. Edna's BareEASE, the
skin anesthetizer and moisturizer she
dreamed up after receiving her first
"needlessly painful" Brazilian bikini wax.
Her inspiration (osmag.net/7YbRNj) came
in part from EMLA cream, the local anes-
thetic. — Bill Donahue
IN THE SPOTLIGHT
Dr. Ma Shines on Reality TV
Shows Survivor and Shark Tank
• BIG FISH Dr. Ma on Shark Tank.
• CASTAWAY Dr. Ma on Survivor: South Pacific.
