Dear All,
The era of
big cuts into patients is almost extinct for all types of surgery from routine
Open Prostatectomy, Cholecystectomy, Hysterectomy, Bariatric surgery, joint
replacement, to pancreatic transplantation, Heart Valve Replacement, and so on
and so on - Anaesthesia too has become very patient friendly and centred
:
It shall
soon bother on best practice and ethical standards as regulatory bodies take
stock if doctors continue to practice methods long ascribed to the museum of
medicine:
READ ON -
Evening
Standard – 30 June 2017
‘’Doctor keeps patients 'awake' for surgery in pioneering initiative that avoids risks of general anaesthetic
‘’Doctor keeps patients 'awake' for surgery in pioneering initiative that avoids risks of general anaesthetic
Patients are
being kept awake during surgery under a pioneering initiative that avoids the
risks around general anaesthetic and speeds up recovery.
The
ground-breaking treatment is being offered at Central Middlesex Hospital
in Acton by
consultant shoulder and elbow surgeon Nick Ferran.
He has
performed about 50 “awake” operations since joining London North West
Healthcare NHS Trust a year ago. He is believed to be the only surgeon in the
capital routinely doing so on upper limb injuries.
It enables
patients to watch keyhole procedures on TV screens, and allows them to be
discharged earlier.
"Extraordinary"
surgeon Nick Ferran with patient
Doctor Ferran at Central Middlesex Hospital
Rikki Stein
who said his operation was pain-free
Some are
ready to leave 45 minutes after their operation. In addition, surgery can be
offered to patients who cannot have a general anaesthetic, such as a
94-year-old woman who received two new shoulders.
Mr Ferran
said there were many advantages. “It avoids the need for a general anaesthetic,
which can cause cardiac and breathing problems and, in very, very rare cases,
death. It avoids the nausea and vomiting afterwards, which some patients can
experience and which a lot of patients are worried about.
“It also
allows for good pain relief because the surgical site is numb, and usually for
24 hours. It means their first night’s sleep after surgery is usually a lot
more comfortable. The recovery is quicker. They can eat and drink as soon as
the operation is over, and because they have got good pain relief they can
usually leave hospital quicker.”
Awake
surgery has been routine for hip and knee surgery for some time, and is used
occasionally in neurosurgery. Mr Ferran’s patients are administered “nerve
block” by consultant anaesthetist Dr Amit Saxena, who uses ultrasound to ensure
the area being operated on is “bathed” in anaesthetic.
Extra pain
relief and sedation are available if they start to feel pain. Patients can also
be “converted” to general anaesthetic. Awake surgery is not offered to patients
who cannot speak English, as they need to be able to communicate throughout.
Mr Ferran
said: “There will be times when the patient might feel something sharp, or
might feel discomfort, and they need to be able to tell me straight away. We
have very strong painkillers that can act within 30 seconds.”
Nathan
Gonzales-Brown, 19, an apprentice from Acton who dislocated his shoulder
boxing, was anxious that the nerve block drugs had not worked, and was given
sedatives. But 30 minutes into the procedure, he told the Standard: “I don’t
feel anything. It’s quite interesting [to see it] at the same time.”
Rikki Stein,
74, from Edgware, who was having a torn shoulder tendon repaired, said: “It’s
an extraordinary experience. I was pain-free and fascinated by the whole
process. The anaesthetic is extraordinary. I was aware of them doing it, but I
couldn’t feel it.”
Joseph Ana.
Africa Center for Clin Gov Research &
Patient Safety
@ HRI West Africa
Group - HRI WA
Consultants in
Clinical Governance Implementation
Publisher: Health and
Medical Journals
8 Amaku Street Housing
Estate, Calabar
Cross River State, Nigeria
Cross River State, Nigeria
Phone No.
+234 (0) 8063600642
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