Cardiac Bypass underepidural, First cases in UK
Heart patient stays awake for bypass surgery
By Sarah Womack, Social Affairs Correspondent
(Filed: 14/08/2003)
Surgeons have performed Britain"s first heart bypass while the patient is still awake. The ground-breaking operation means that instead of being given a general anaesthetic, the patient is given an epidural injection.
A spokesman for Harefield Hospital in Middlesex said two patients had successfully undergone the procedure - coronary artery heart bypass grafts - while awake.
The first, John Phillipson, 73, from Watford, said he felt terrific afterwards. "I didn"t feel anything. It was just like a routine operation."
Mohamed Amrani, the Belgium-born consultant cardiac and transplant surgeon who performed the operation, said: "Mr Phillipson was cracking jokes."
Mr Amrani said the procedure helped patients to recover more quickly and could be used on people who might not be well enough to have major open heart surgery and a general anaesthetic.
In the case of Mr Phillipson, a retired engineer who is married with three daughters, he was given an epidural to his spine before undergoing a single heart bypass.
The dosage was similar to that given to women who are about to have a caesarean section. Surgeons then used keyhole surgery to repair his damaged artery. He left hospital two days later.
Mr Amrani said: "We can reduce a major source of invasiveness in surgery and, by avoiding general anaesthetics, we can improve the patient"s comfort. A lot of patients are worried that after a general anaesthetic they won"t wake up."
He said that being awake did not mean the patient witnessed what was going on. "There is a screen between them and what we are doing."
Doctors at the hospital, which is part of the Royal Brompton NHS Trust, are planning to offer suitable heart patients the choice of staying awake during their operation.
Heart bypass surgery is a common operation to improve blood flow to the heart and is needed by at least 20,000 people in Britain every year.
However the technique is unlikely to become widely available in Britain in the near future because of the need to train anaesthetists to administer the epidural correctly.
The British Heart Foundation said: "This technique is a positive step forward. But larger controlled trials will be needed before epidural anaesthesia can be used in place of other established surgical procedures."
Mr Amrani said: "We are going to offer it to most of our patients." It could cut overall costs "dramatically".
Mr Phillipson, who was operated on in the morning, was sitting up in bed, reading a newspaper and eating, by the afternoon. He had a heart attack earlier this year.
"The whole experience was amazing," he said. "The surgeons asked if I knew any good jokes so I racked my brains and told them a few."
เอ้า..อาจารย์อ๊อด อาจารย์เอก เราไม่ต้องดมยาก็ผ่า Bypass ได้แล้วนะครับ คนไข้จะกลายเป็น OPD case ในอีกไม่นานนี้แล้วมั้ง?
Posted by : Phoenix , Date : 2003-08-14 , Time : 22:23:19 , From IP : 172.29.3.248
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