Attention: Patient is awake!
You Have Options – Sedation or Staying Conscious.
Remaining awake during surgery is becoming a popular choice. This is not for everyone, but many patients prefer to have their eyes wide open vs. being sedated during certain surgeries.
Why would an individual choose to stay awake during their own surgery? Medical and financial factors are typically the primary reasons for choosing to stay awake; however, some patients like the option of being able to communicate during the surgery.
Many hand and arm surgeries performed by our surgeons offer regional blocks or local numbing shots instead of general anesthesia. This means fewer side effects and risks associated with general anesthesia such as vomiting, drowsiness, and stress to the heart and lungs. Regional blocks and local injections also allow for quicker recovery and less cost.
Our patient, Lisa Haak, recently underwent carpal tunnel surgery at Woodland Surgery Center and opted to forego sedation. A local anesthetic was used in place of the sedation. Although she was hesitant, she was determined to overcome her anxiety of the operating room and forego the side effects of general anesthesia.
One week postoperative carpal tunnel surgery.
As the surgery time approached, the anesthesiologist and expert surgical team made her feel calm and assured her she would do just fine. Once in the operating room, and with total confidence in her surgeon and his team, she relaxed and remained calm throughout the experience. Music and local artists were the subjects of discussion, to the point of requesting her favorite radio station be tuned in!
At the conclusion of her surgery, she was asked how things went, and her comments were simple and to the point: “It was a piece of cake! Very assuring surgical team and Dr. Van Zeeland was just great. She even had an extensive discussion with Dr. Van Zeeland on his wife’s favorite local artist!” Haak stated she would definitely do the local anesthetic again if she needs surgery on her other wrist.
Three weeks postoperative carpal tunnel surgery.
Many patients worry about becoming anxious in the operating room. This is not uncommon since the operating room is an unknown place to them. It’s scary. Actually, being awake in minor surgeries is not that uncommon. Dental procedures, Cesarean sections and certain brain surgeries even forgo general anesthesia if communication with the patient is necessary during the procedure.
At Hand to Shoulder Center of Wisconsin, we perform minor surgeries such as trigger finger release and skin lesion excision using regional nerve blocks or local anesthetics in our in-office procedure rooms. For more involved surgeries that require a surgical facility, Woodland Surgery Center or one of our three additional surgery sites are utilized. In 2017, roughly 32% of surgeries performed at Woodland Surgery Center utilized local anesthetic in place of sedation medication. Regional nerve blocks and local anesthetics are often used by our surgeons in surgeries that include but are not limited to:
- Carpal tunnel release
- Certain fracture fixations/manipulations
- Extensor tendon repairs/transfers
- DeQuervain’s release
- Mallet finger pinning
- Mass excision
- Needle aponeurotomy for Dupuytren’s contracture
- Retinacular cyst excisions
For the orthopedic cases above, the patient and surgeon can decide if staying awake is the best option. In more complex cases, the option of staying awake vs. sedation depends on the amenability of the surgery, the willingness and decision of the orthopedic surgeon, the flexibility of the anesthesiologist and the facility’s ability to customize the procedure.