The ‘miracle’ of (general) anaesthesia does not work for everyone, apparently.

Some patients would really rather watch their surgeons work on them in the operation theatre. It could be a very interesting once-in-a-lifetime experience for the ‘medically-inclined’, perhaps stemming more from their own curiosity or knowing that this could be a good conversation-opener post-op.

Why some patients shun away from sedation


According to an article by the New York Times, orthopaedics is top on the list for surgeries that patients undergo while awake. Other specialties are also fast following suit, like breast, colorectal, thoracic vascular and urological, among several others.

On one hand, there are some patients who have the genuine fear of not ‘being able to wake up’ after being sedated. They could also have a general distaste for chemicals and intend to keep any amount of drugs in their body as minimal as possible.

Others want to avoid experiencing the side effects they have read about, like nausea and vomiting. For the rest, they are overwhelmed by their own inquisitiveness, probably thanks to television programmes or YouTube videos, flaring up their interest on the occupation of certain medical fields. Perhaps, it could also be more patient-satisfying to see for oneself the ‘culprit’ that was the source of their medical problem and witnessing it being finally removed from the body.

However, the experience can be unnerving for surgeons and the medical team as it might interfere with patient safety. Firstly, a patient can be unsettled by the silence that permeates the procedure, briefly interrupted by the ‘clinks and clanks’ of metallic equipment.

The team needs to be fully focused on the operation, and having to keep a wide-eyed patient occupied is, after all, an additional task. The environment of the operation theatre – brightly-lit, cold and unfriendly – could be sending negative vibes to the layman.

The negative effects of sedation


A surgical procedure can be lengthy and lacks the “adrenaline rush” that the patient had mistakenly anticipated earlier. Having to remain in one position and seeing the monotony in the actions could make a patient grow bored eventually. An ‘unwanted’ conversation could follow suit, which could distract the surgeon and the team.

Nonetheless, medical professionals who are supportive of this likened it to creating a “different kind of surgeon-patient relationship”, seeing it is as a positive step towards greater transparency. One thing for sure, having a surgery with the patient being awake is a no-no for any faint-hearted patient.

What is crucial is that the patient is informed of the importance of safety and how the surgeon needs to focus fully on his work and communicate with other members of the team, with no interruption. An understanding of expectations from both doctor and patient will help make the process easier.

After all, patients want to hear confidence in their doctors, not some ‘office banter’, although the operation room would be a typical ‘office’ for surgeons and the operating team. MIMS

Read more:
Unlocking the puzzle of resistance to anaesthesia
World Anaesthesia Day: A timeline of how medicine has taught us to control pain
Can it wait till the morning? Nocturnal surgeries found to double mortality risks

Sources:
https://www.nytimes.com/2017/03/25/health/surgery-awake-anesthesia.html?_r=0