Awake surgery makes gains

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readerc54

Awake surgery makes gains

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From NY Times

BENSALEM, Pa. — “Do you want to see your tendons?”

Dr. Asif Ilyas, a hand and wrist surgeon, was about to close his patient’s wound. But first he offered her the opportunity to behold the source of her radiating pain: a band of tendons that looked like pale pink ribbon candy. With a slender surgical instrument, he pushed outward to demonstrate their newly liberated flexibility.

“That’s pretty neat,” the patient, Esther Voynow, managed to gasp.

The operation Dr. Ilyas performed, called a De Quervain’s release, is usually done with the patient under anesthesia. But Ms. Voynow, her medical inquisitiveness piqued and her distaste for anesthesia pronounced, had chosen to remain awake throughout, her forearm rendered numb with only an injection of a local anesthetic.

More surgery is being performed with the patient awake and looking on, for both financial and medical reasons. But as surgical patients are electing to keep their eyes wide open, doctor-patient protocol has not kept pace with the new practice. Patients can become unnerved by a seemingly ominous silence, or put off by what passes for office humor. Doctors are only beginning to realize that when a patient is alert, it is just not O.K. to say: “Oops!” or “I wasn’t expecting that,” or even “Oh, my God, what are you doing?!”

Studies show that regional anesthesia has fewer complications than general anesthesia and is less expensive. Recovery time is swifter and side effects are fewer, which can reduce the need for postoperative opioids.

https://www.nytimes.com/2017/03/25/heal ... hesia.html
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