Surgeries in which the patient is awake?

[surgeon_hopeful]

Hi,

Recently I asked for help on a research question. Well, after doing some of my own research, the idea of performing surgeries in which a patient is awake seemed to spark my interest. So I was wondering if anyone knows about any research being done in the field by any chance? I have to run it by my teacher to make sure it fits the IB extended essay criteria, but yeah, can anyone help me with that part?

Also, what are the types of local anaesthesia given that numb either the brain or heart (becuase these are the systems I'm most interested in). Or, even better, does anyone have a link that explains the different chemicals (types of local anaesthesia) given for each region of the body?

thanks in advance (wikipedia didn't help too much on the second part )

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[Mman]

Well, there are a ton of C-sections done every single day with the mom awake under a spinal anesthetic.

As for the "brain or heart" that you refer to, I don't think anybody is actually awake for any type of heart surgery. Brain surgery isn't totally awake, but more of an asleep-awake-asleep sort of scenario. The brain itself doesn't have any innervation and therefore isn't a source of pain during surgery. It's the whole cutting through skull part that is painful which they are asleep for.

I'm not sure what your question is really. For any sort of regional technique (epidural, spinal, peripheral block), the patient receives a local anesthetic such as lidocaine or bupivicaine or ropivicaine in the desired location to produce anesthesia in the intended area.

 

[Gern Blansten]

CABG done under accupuncture??

 

[Monty Python]

CABG done under accupuncture??

There are reports of CABG done under high thoracic epidural (from memory I believe in S. America) on GASnet: www.gasnet.med.yale.edu

 

[zippy2u]

Well, any surgery where ya forgot to turn on the volatile agent after they were paralyzed with pavulon--- I hate surgeries like that. ---Zippy

 

[jennyboo]

I had to look up what the 'IB extended essay' is but now that I figured it out, here are some thoughts in response to you (very broad) question.

You will, obviously, have to pick a much narrower topic. "Surgery while awake" encompasses many different types of surgery and types of "awakeness" which are not related to each other at all and which include many different topics. Broadly speaking, in as non-medical terminology as I can make it, you can have:

1) Surgery under local, regional, or spinal/epidural anaesthetic. Obviously, if you anaesthetise just the part that is being operated on, there's no need for someone to go to "sleep" for the procedure. This includes all sorts of things including some orthopedic procedures (i.e. on the arms or legs), Caesarean sections (frequently under epidural anaesthesia), and more stuff.

2) Surgery in which the patient "sleeps" but you wake them up in the middle of the procedure. This may occur during neurosurgical or orthopaedic procedures on the brain or spine, or during carotid surgery for example.

3) Awareness during general anaesthesia -- a widely discussed topic -- in which the awareness is unintended.

I think I would probably approach it by choosing one type of surgery and then focusing the essay on discussing whether the "awake" approach specific to that procedure has better or worse outcomes than the traditional "non-awake" approach. That would make it much more manageable to write about.