Is Staying Awake During Your Surgery an Option?

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Surgery is not something to take lightly.  When it is a must for your health, consider your options of staying awake during the procedure.  There are risks associated with general anesthesia, not to mention recovery time and the costs involved – you may wish to discuss with your doctor the alternative of remaining awake during surgery.  Here is some information shared by to have nestled in your brain that you will hopefully never have to consider again. Though what a blessing to know “just in case” – numbered resources can be viewed in the original article.

During Which Types of Surgery Can Patients Stay Awake? – Not every hospital offers patients the “awake” option, even in surgeries for which it’s conducive, because it requires a customized experience. The surgeon must also be willing and the patient must be able to handle the procedure without becoming overly stressed or anxious.

Assuming all of this lines up, orthopedic procedures, such as hand, knee or wrist surgery, are among the most common procedures now performed with patients awake but, as reported by The New York Times, “surgery in breast, colorectal, thoracic, vascular, otolaryngological, urological, ophthalmological and cosmetic specialties is also moving in this direction.”1 Research suggests many patients have a favorable experience with the “wide awake approach.”

In a study of the use of local anesthetics in hand surgery, 83 percent said they would choose this form of anesthesia again if they needed another operation.2 In another study, patients were equally satisfied on average whether they received local anesthesia or sedation.3

What Are the Benefits of Staying Awake During Surgery? – One of the primary benefits is avoiding the risks that come along with general anesthesia, which can be significant. Research published in the journal Anesthesiology compared the effectiveness of local versus general anesthesia for hip fracture surgery and found the local anesthesia was associated with better outcomes. “Regional anesthesia is associated with a lower odds of inpatient mortality and pulmonary complications among all hip fracture patients compared with general anesthesia,” the researchers wrote.4

Further, with local anesthesia recovery time is reduced, as is the cost of surgery. Patients who undergo sedation spend more time at the hospital, require more pre-operative testing and also report greater anxiety prior to surgery.5 An analysis of 100 wide awake hand surgery procedures performed at a military medical center also revealed significant cost savings compared to general anesthesia. For two procedures (carpal tunnel release and A1 pulley release), an 85 percent and 70 percent cost savings were reported, respectively.6

Wide Awake Surgery May Not Be for Everyone – There are some additional considerations to take into account when considering staying awake during surgery. Practical issues, like staying in one position for hours at a time, with nothing to keep you occupied, should not be ignored. Also consider how you’ll react if you can feel pressure and vibrations from cutting or even smell burning flesh during the surgery. It’s a good idea to ask your surgical team what to expect so you can be mentally as well as physically prepared.

It’s important to keep in mind that, even without general anesthesia, surgery still carries risks, including infection. You’ll want to explore all of your potential treatment options prior to deciding on surgery of any kind.

Be Sure the Surgery Is Necessary First – If you do, in fact, need surgery, the newer awake options, which allow you to avoid the many pitfalls of general anesthesia, are likely to be beneficial. However, if your physician tells you that you need surgery, unless it is an emergency, I would strongly recommend you get a second opinion first. In many cases, you may find that you don’t need surgery after all, saving not only a considerable amount of money, but also avoiding the potentially deadly risks that any surgery carries. Tens of thousands of patients undergo unnecessary surgery each and every year, and you don’t want to be one of them.17

If you’re considering surgery — even awake surgery — it’s always a good idea to get a second opinion — and possibly a third and fourth. The other key is to be proactive and start pursuing a healthy lifestyle today so you don’t become a victim of an unnecessary medical procedure.

I experienced a huge ‘live and learn’ lesson several years ago after having a hysterectomy… Some of the surgeries our doctors recommend are not necessarily the ‘best long-term outcome’ for our health issue (research ALL options and get more than one opinion!)  If there is no other option for your health concern, discuss the possibility of “Awake Surgery” with your doctor.

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