Paul Frederick White

Last updated

Paul F. White
Born
La Mesa, California
Education
OccupationDirector of Research, Department of Anesthesiology
EmployerCedars-Sinai Medical Center

Paul Frederick White, FANZCA is a researcher in anesthesiology, research consultant at Cedars-Sinai Medical Center at Los Angeles, retired professor and former holder of the Margaret Milam McDermott Distinguished Chair of Anesthesiology at The University of Texas Southwestern Medical Center at Dallas, and the author and editor of several journals and textbooks on the subject. With over 450 peer-reviewed publications and authorship in 9 anesthesiology textbooks, White has helped shape and revolutionize the field of ambulatory anesthesia and intravenous anesthesia.

Contents

Education and career

White graduated from an honors program in Biochemistry at the University of California, Berkeley with Distinction in 1970. He subsequently earned his PhD (Pharmacology) and MD degrees from the University of California, San Francisco. White obtained postgraduate training in both Internal Medicine and Anesthesiology at UC San Francisco, and has board certification in both medical specialties. In 1980, he joined the faculty at Stanford University and became a tenured associate professor and chief of the Outpatient Anesthesiology Service at the University Hospital. In 1988, he accepted the position of professor and vice-chair of clinical research in the Department of Anesthesiology at Washington University in St. Louis. He also served as the medical director of the Barnes Hospital Day Surgery Center. In 1992, he was appointed professor and chairman of the Department of Anesthesiology and Pain Management at the University of Texas Southwestern Medical Center. In June 2011, he retired from the Margaret Milam McDermott Distinguished Chair of Anesthesiology at UT Southwestern. He serves as a representative from the Department on the advisory board of the institution's new Center for Minimally Invasive Surgery. White has also served as a non-paid consultant to the Departments of Anesthesia at both Ohio State University (for ambulatory surgery) and Cedars Sinai Medical Center in Los Angeles (for clinical research and continuing education programs). He has an appointment as a director of research at Cedars Sinai Medical Center for the Department of Anesthesiology. [1] He has also given seminars as a visiting professor at the Renaissance School of Medicine at Stony Brook University Department of Anesthesiology in November 2005 ("Role of Non-Opioid Analgesics," "Fast-Tracking Anesthetic Techniques") and September 2008 ("Ambulatory Anesthesia: Optimal Anesthetic Techniques"). [2]

White has edited nine books, including major textbooks on the subspecialties of ambulatory anesthesia and intravenous anesthesia. White has also contributed 88 chapters to textbooks edited by colleagues from around the world. In addition to publishing over 450 peer-reviewed articles, White has written 14 editorials and published over 500 scientific abstracts. Two of White's peer-reviewed publications were listed among the "Top 10" most cited articles in Anesthesiology (and he has the second most citations by any individual author in the specialty). White studies have appeared in USA Today, [3] Washington Post, [4] Wall Street Journal, [5] and other media outlets. White has trained more than 65 postgraduate clinical research fellows during his academic career. He has given over 450 domestic and 390 international lectures. In addition, White has performed over 100 Visiting Professorships in the United States and abroad. White is acknowledged by his colleagues as an international leader in the fields of ambulatory anesthesia and pain management, and has been recognized in the "Best Doctors in America" and "Who's Who in North America." He was awarded the Distinguished Service Award by the Society for Ambulatory Anesthesia, and the Dannemiller Memorial Foundation's award for "Educational Excellence in Anesthesiology."

White has served on the board of directors of three major anesthesia organizations (namely, the Society for Ambulatory Anesthesia [SAMBA], the Society for Intravenous Anesthesia [SIVA], and the International Society for Anaesthetic Pharmacology [ISAP]). White served as the president of the SAMBA organization from 1994 to 1995 and as president of SIVA/ISAP from 1999 to 2000. In addition, White has served as chairman of the Anesthesiology Panel (1985–2000) and was a member of the executive committee of the United States Pharmacopoeia (1995–2000). White has been appointed to five international editorial boards and formerly served as the section editor for ambulatory anesthesia for Anesthesia & Analgesia [6] and the Journal of Clinical Anesthesia. [7] As of April 2019, he is no longer on the editorial board of Anesthesia & Analgesia. [8] Nor is he currently on the board of the Journal of Clinical Anesthesia. [9]

Finally, White has established a not-for-profit foundation (the White Mountain Institute [10] ) to advance education in the creative arts and medicine throughout the world.

White's brother, Ed White, is a former UC Berkeley hall of fame and NFL all pro offensive lineman who played 17 years for the San Diego Chargers and Minnesota Vikings. Ed is an All-time Charger and All-time Viking.

One of his most recent publication in the Journal of Clinical Anesthesia ("Expanding role of multimodal analgesia in facilitating recovery after surgery: From fast-tracking to enhanced recovery") published online 7 January 2019, he is listed as the president of The White Mountain Institute, The Sea Ranch, California. The White Mountain Institute is a not-for-profit private foundation (Federal Tax ID #77-0094396) dedicated to supporting medical education, art and student-athletes.

Defense expert in Conrad Murray trial

In late October 2011, White testified as a defense expert in the trial that found Dr. Conrad Murray guilty [11] of the involuntary manslaughter of Michael Jackson. [12] White testified that the models used by the prosecution's expert, Dr. Steven Shafer, did not show how Jackson would have responded to the drug propofol. [12] White was one of the first to test propofol, and his clinical trial led to approval of the drug by the Food and Drug Administration. [12] White also stated that Murray's treatment of Jackson with propofol was not inappropriate because off-label drug use by doctors is not uncommon or illegal. [12]

In his second day on the stand, White testified that Jackson probably caused his death by injecting himself with propofol while Murray was not looking. White based his conclusion on the level of propofol in Jackson's urine during the autopsy. [13] White also testified that Jackson had taken several tablets of lorazepam, a sedative, which, in conjunction with the propofol, would have killed Jackson instantly. [13]

On cross-examination, White conceded that Murray had violated the standard of medical care by administering propofol in a home setting. [14]

At a hearing on November 16, 2011, Judge Michael Pastor found White in contempt for referring to his discussions with Murray during White's testimony, even though had been warned not to do so. He was fined $250. [15]

Key research/publications

Related Research Articles

Ketamine Dissociative medication

Ketamine is a medication primarily used for starting and maintaining anesthesia. It induces dissociative anesthesia, a trance-like state providing pain relief, sedation, and amnesia. The distinguishing features of ketamine anesthesia are preserved breathing and airway reflexes, stimulated heart function with increased blood pressure, and moderate bronchodilation. At lower, sub-anesthetic doses, ketamine is a promising agent for pain and treatment-resistant depression. However, the antidepressant action of a single administration of ketamine wanes with time, and the effects of repeated use have not been sufficiently studied.

Anesthesia State of medically-controlled temporary loss of sensation or awareness

Anesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness. A patient under the effects of anesthetic drugs is referred to as being anesthetized.

Dissociatives are a class of hallucinogen which distort perception of sight and sound and produce feelings of detachment – dissociation – from the environment and/or self. Although many kinds of drugs are capable of such action, dissociatives are unique in that they do so in such a way that they produce hallucinogenic effects, which may include sensory deprivation, dissociation, hallucinations, and dream-like states or anesthesia. Some, which are nonselective in action and affect the dopamine and/or opioid systems, may be capable of inducing euphoria. Many dissociatives have general depressant effects and can produce sedation, respiratory depression, analgesia, anesthesia, and ataxia, as well as cognitive and memory impairment and amnesia.

Sevoflurane Chemical compound

Sevoflurane is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used as an inhalational anaesthetic for induction and maintenance of general anesthesia. After desflurane, it is the volatile anesthetic with the fastest onset. While its offset may be faster than agents other than desflurane in a few circumstances, its offset is more often similar to that of the much older agent isoflurane. While sevoflurane is only half as soluble as isoflurane in blood, the tissue blood partition coefficients of isoflurane and sevoflurane are quite similar. For example, in the muscle group: isoflurane 2.62 vs. sevoflurane 2.57. In the fat group: isoflurane 52 vs. sevoflurane 50. As a result, the longer the case, the more similar will be the emergence times for sevoflurane and isoflurane.

General anaesthesia Medically induced coma

General anaesthesia or general anesthesia is a medically induced coma with loss of protective reflexes, resulting from the administration of one or more general anaesthetic agents. It is carried out to allow medical procedures that would otherwise be intolerably painful for the patient, or where the nature of the procedure itself precludes the patient being awake.

Anesthesiology Medical specialty concerned with anesthesia and perioperative care

Anesthesiology is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in anesthesiology is called an anesthesiologist. There are different ways of referring to the field of anesthesiology and physicians who specialize in it depending on the region of the world.

Propofol Intravenous medication used in anaesthesia

Propofol, marketed as Diprivan, among other names, is a short-acting medication that results in a decreased level of consciousness and a lack of memory for events. Its uses include the starting and maintenance of general anesthesia, sedation for mechanically ventilated adults, and procedural sedation. It is also used for status epilepticus if other medications have not worked. It is given by injection into a vein, and the maximum effect takes about two minutes to occur and typically lasts five to ten minutes. Propofol is also used for medical assistance in dying in Canada.

Anesthetic Drug that causes anesthesia

An anesthetic or anaesthetic is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad classes: general anesthetics, which result in a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.

Awareness under anesthesia, also referred to as intraoperative awareness or accidental awareness during general anesthesia (AAGA), is a rare complication of general anesthesia where patients regain varying levels of consciousness during their surgical procedures. While anesthesia awareness is possible without resulting in any long-term memory, the more clinically significant complication is awareness with explicit recall, where patients can remember the events related to their surgery.

Epidural administration Medication injected into the epidural space of the spine

Epidural administration is a method of medication administration in which a medicine is injected into the epidural space around the spinal cord. The epidural route is used by physicians and nurse anesthetists to administer local anesthetic agents, analgesics, diagnostic medicines such as radiocontrast agents, and other medicines such as glucocorticoids. Epidural administration involves the placement of a catheter into the epidural space, which may remain in place for the duration of the treatment. The technique of intentional epidural administration of medication was first described in 1921 by Spanish military surgeon Fidel Pagés. In the United States, over 50% of childbirths involve the use of epidural anesthesia.

Remifentanil synthetic opioid analgesic

Remifentanil is a potent, short-acting synthetic opioid analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. Remifentanil is used for sedation as well as combined with other medications for use in general anesthesia. The use of remifentanil has made possible the use of high-dose opioid and low-dose hypnotic anesthesia, due to synergism between remifentanil and various hypnotic drugs and volatile anesthetics.

The Outcomes Research Consortium is an international clinical research group that focuses on the perioperative period, along with critical care and pain management. The Consortium's aim is to improve the quality of care for surgical, critical care, and chronic pain patients and to “Provide the evidence for evidence-based practice.” Members of the Consortium are especially interested in testing simple, low-risk, and inexpensive treatments that have the potential to markedly improve patients’ surgical experiences.

Scott S. Reuben is an American anesthesiologist who was Professor of Anesthesiology and Pain Medicine at Tufts University in Boston, Massachusetts and chief of acute pain at Baystate Medical Center in Springfield, Massachusetts from February 1991 until 2009 when he was sentenced to prison for healthcare fraud. Reuben was considered to be a prolific and influential researcher in pain management, and his purported findings altered the way millions of patients are treated for pain during and after orthopedic surgeries. Reuben has now admitted that he never conducted any of the clinical trials on which his conclusions were based "in what may be considered the longest-running and widest-ranging cases of academic fraud." Scientific American has called Reuben the medical equivalent of Bernie Madoff, the former NASDAQ chairman who was convicted of orchestrating a $65-billion Ponzi scheme.

Twilight anesthesia Anesthetic technique

Twilight anesthesia is an anesthetic technique where a mild dose of sedation is applied to induce anxiolysis, hypnosis, and anterograde amnesia. The patient is not unconscious, but sedated. During surgery or other medical procedures, the patient is under what is known as a "twilight state", where the patient is relaxed and "sleepy", able to follow simple directions by the doctor, and is responsive. Generally, twilight anesthesia causes the patient to forget the surgery and the time right after. It is used for a variety of surgical procedures and for various reasons. Just like regular anesthesia, twilight anesthesia is designed to help a patient feel more comfortable and to minimize pain associated with the procedure being performed and to allow the medical practitioner to practice without interruptions.

People v. Murray was the American criminal trial of Michael Jackson's personal physician, Conrad Murray, who was charged with involuntary manslaughter for the pop singer's death on June 25, 2009, from a massive overdose of the general anesthetic propofol. The trial, which started on September 27, 2011, was held in the Los Angeles County Superior Court in Los Angeles, California, before Judge Michael Pastor as a televised proceeding, reaching a guilty verdict on November 7, 2011.

The following outline is provided as an overview of and topical guide to anesthesia:

Steven Shafer is a professor of anesthesiology at Stanford University. In 2011, the International Society of Anaesthetic Pharmacology gave him their lifetime achievement award.

Obstetric anesthesia or obstetric anesthesiology, also known as ob-gyn anesthesia or ob-gyn anesthesiology is a sub-specialty of anesthesiology that provides peripartum pain relief (analgesia) for labor and anesthesia for cesarean deliveries ('C-sections').

Alex Bekker Physician, author and academic

Alex Bekker is a physician, author and academic. He is a Professor and Chair at the Department of Anesthesiology, Rutgers New Jersey Medical School. He is also Professor at the Department of Physiology, Pharmacology & Neurosciences. He serves as the Chief of Anesthesiology Service at the University Hospital in Newark.

Total intravenous anesthesia (TIVA) refers to the intravenous administration of anesthetic agents to induce a temporary loss of sensation or awareness. The first study of TIVA was done in 1872 using chloral hydrate, and the common anesthetic agent propofol was licensed in 1986. TIVA is currently employed in various procedures as an alternative technique of general anesthesia in order to improve post-operative recovery.

References

  1. ↑ Cedars-Sinai Department of Anesthesiology Archived August 6, 2018, at the Wayback Machine . Retrieved November 14, 2009.
  2. ↑ Stony Brook University Renaissance School of Medicine. Retrieved January 18, 2019.
  3. ↑ Killing pain one drip at a time. Retrieved April 25, 2008.
  4. ↑ Doctors Lift Ban on Presurgery Liquids; Water, Apple Juice, Black Coffee May Help, Anesthesiologists Say. Retrieved April 25, 2008.
  5. ↑ Who Will Pay High Cost Of Relief From Pain?. Retrieved April 25, 2008.
  6. ↑ Paul White, Anesthesia & Analgesia, Section Editor. Retrieved April 25, 2008.
  7. ↑ Journal of Clinical Anesthesia Editorial Board. Retrieved April 26, 2008.
  8. ↑ Editorial Board: Anesthesia & Analgesia. Retrieved April 3, 2019.
  9. ↑ Editorial Board: Journal of Clinical Anesthesia. Retrieved April 3, 2019.
  10. ↑ White Mountain Institute. Retrieved April 25, 2008.
  11. ↑ "L.A. Now". Los Angeles Times.
  12. 1 2 3 4 Ryan, Harriet; Kim, Victoria (October 28, 2011). "Witness says Jackson doctor's actions can't be justified". Los Angeles Times. Retrieved November 4, 2011.
  13. 1 2 Ryan, Harriet; Kim, Victoria (October 29, 2011). "Michael Jackson probably caused his own death, witness testifies". Los Angeles Times. Retrieved November 4, 2011.
  14. ↑ Ryan, Harriet (October 31, 2011). "Defense expert concedes Conrad Murray violated medical care standards". Los Angeles Times. Retrieved November 4, 2011.
  15. ↑ Duke, Alan (November 16, 2011). "Expert fined for contempt in Conrad Murray trial". CNN. Retrieved November 17, 2011.
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