Recently, we read with interest a news story featured in the Evening Standard about a “pioneering initiative” known as awake surgery.
Referred to as a groundbreaking treatment option, it highlighted the benefits of patients undergoing shoulder and elbow surgery under new ‘awake’ regional anaesthesia. The newspaper claimed that a shoulder and elbow surgeon at a London hospital was one of the first to offer this innovative technique on upper limb injuries, having carried out 50 of these cases over the last year.
While it’s true that awake surgery does deliver some benefits over surgery carried out under general anaesthetic, there were a couple of significant errors in this news story. This isn’t a new technique and it is used routinely in orthopaedic operations. Our shoulder specialists have been carrying out awake regional anaesthetic procedures for over 15 years, equating to approximately 3,000 cases.
And, for some patients, a general anaesthetic combined with regional anaesthetic techniques to ensure optimal pain relief and earlier mobilisation will always be the preferred option.
Below, you’ll discover everything you need to know about the awake surgery technique, its benefits and the importance of choosing a reliable, highly experienced surgeon.
What is awake shoulder surgery?
Awake shoulder surgery enables the patient to stay awake throughout the procedure. However, most patients choose to be sedated to some degree.
An anaesthetist will inject medication near the nerves surrounding the shoulder and the surrounding area. This will numb the area where the surgery will be performed. It takes approximately 30 minutes for the anaesthesia to be injected and take effect.
The types of awake surgical procedures vary and will be selected based upon the injury being treated.
Benefits of awake shoulder surgery procedures
So, why are awake regional anaesthetic procedures being described as a pioneering technique? Some patients can suffer from side effects from general anaesthesia, such as nausea and dizziness, and, if patients have suffered from these side effects in the past, then these can be mitigated with awake sedation techniques.
In general, though, a general anaesthetic is very safe and well-tolerated and for many patients, shoulder surgery performed under a general anaesthetic augmented with a regional block can be the best option, depending on the patient’s health and fitness and whether major surgery of a much longer duration is required. Both patient and surgical factors will be taken into account in the pre-operative planning stage.
The biggest benefit of awake surgery is a faster recovery time from the anaesthesia, however most shoulder operations are relatively short in duration, hence even with a general anaesthetic combined with a regional block, most patients are able to go home the same day. Whilst some people like to watch their own surgery, for others, this is not so desirable!
The importance of choosing an experienced surgeon
As you can see, there are plenty of excellent benefits that come from undergoing awake regional surgery. However, to enjoy these benefits it’s important to choose an experienced surgeon who has been performing this type of operation for many years and can advise on the best option for you.