Awake Surgery

Surgery without putting patient asleep

For most people surgery means anesthesia and anesthesia is equal to general anesthesia or narcose. But sometimes it is not easy to perform operations under general anesthesia because of the limitation of anesthesiologist and operating room equipped for general anesthesia. In most hospitals surgical specialities have a room for local anesthesia cases without an anesthesiologist. However in these rooms only small and short operations had been done because of the short efficient time of local anesthetic drugs. The most important factor restricting the large area local anesthesia is pain of the injections. A small area can be anesthetized with one needle puncture but large areas need several needle puncture. But if you learn how to make local anesthesia in a minimal painful way it gives you a huge advantage.

Why awake surgery is preferred

A surgeon can perform safe and effective local anesthesia most of the hand operations, facelifts, brow forehead and neck operations could be done completely awake. Local anesthesia is also used in these operations today but with the help of sedation which is done by an anesthesiologist. Some surgeons claim that major complications are related to the sedation. Nausea, vomiting, pulmonary problems and breathing difficulties are directly related to the sedative drugs. One other advantage of the awake surgery is cost efficiency. You don’t have to pay for an anesthesiologist. On the other hand that doesn’t mean that you can do awake surgery in a simple operating room. The operating room must be equipped with blood pressure monitor, ECG monitor, pulse, oxygen and CO2 monitoring devices. The other most important factor is the surgeon must learn how to do safe local anesthesia and what to do if something goes wrong during surgery in terms of local anesthetic drugs. It is not too difficult if you want to learn these basic emergency treatment procedures.

Risks of awake surgery

There is a risk about awake surgery. Because most of the cosmetologists are non surgeon and even some of them are not medical doctor too. Awake surgery may encourage them to do surgical procedures beyond the border of the cosmetic procedures. Because they sometimes advertise like “we do procedures without the risks of anesthesia”. This is not true. In any surgery there might be unexpected complications and all surgeons must be ready to confront these kind of challenges. If you are doing your surgical procedures in an unqualified operating room there are very little options to save the patient. Although awake surgery is gaining popularity most of the plastic surgeons are still prefer to do local anesthesia under sedation and to work with an anesthesiologist. The advantage of working with an anesthesiologist is the surgeon should not be concerned general condition of the patient and just concentrates to the operation.

The future of awake surgery

Patients are more interested with minimally invasive procedures and small operations without anesthesia. So if plastic surgeons can do most of the operations without general or sedation anesthesia this will result immediate recovery of the side effects of the anesthesia and will be preferred by most patients. For this reason we plastic surgeons should learn “awake surgery” and perform this safely and painlessly. By this way we may better compete with non surgeon “cosmetologists”