Tamil Nadu - Chennai   

Patient awake during bypass

M. Dinesh Varma

CHENNAI: Surgeons at a private hospital here performed a coronary bypass surgery on a diabetic while the patient remained awake.

The 47-year-old woman who had a clot in an anterior vessel underwent the surgery after she was administered epidural anaesthesia, which numbed senses from below the neck. The patient was put on sedatives during the three-hour surgery, touted to be the first such bypass surgery in Tamil Nadu.

"Most importantly, we could avoid using the heart-lung machine, ventilator and the attendant risks of infection", said V. Arun, cardio-thoracic surgeon who, along with colleague S. Visvakumar and anaesthetist R. Rajendran performed the surgery last week at Sooriya Hospital.

This minimally invasive surgery ensures the patient an increased comfort level, reduced ICU stay and low hospitalisation costs. In such surgeries, the ICU stay ranges from between a few hours to a day while the net costs are reduced by around 25 per cent.

The lack of machines and general anaesthesia drugs ease stress for the surgeon as well.

"During an epidural surgery, one can go in for general anaesthesia if the situation so demands," said Dr. Visvakumar, who was also involved in a pioneering surgery to correct a hole in the heart recently which entailed the patient remaining conscious as well.

The surgeons pointed out that while such procedures are gaining popularity the need should be primarily determined by the patient's medical condition.

There are certain complicated cases (high lung pressure or bleeding) where options like a ventilator-supported surgery or administering general anaesthesia remain the best way out.

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