A rare "awake cardiac surgery", in which the patient remains awake throughout the procedure, has been performed by a private hospital here on a 53-year-old man. //
A two graft coronary artery bypass was performed on Nagarajan, a bus conductor, at the Meenakshi Mission Hospital and Research Centre on Monday, the hospital authorities claimed today.
This was the first time the 'awake cardiac surgery' was done in Tamil Nadu, they said.
Dr A R Raguram, Chief Cardiac Surgeon at the MMHRC, told reporters that Nagarajan of Dindigul was admitted with severe chest pain and was advised bypass surgery.
During the surgery, the patient was awake with a continually beating heart as he was not given general anaesthesia. He was talking and joking while his chest was opened and the two grafts were sewen, Raguram said.
According to Dr.S.Kumar, Chief Cardiac Anesthesiologist of MMHRC, this was made possible because the patient's pain sensation was completely arrested in the operation site by selectively blocking nerves using a strategically placed catheter in the back and continuously injecting drugs. This is called cervical epidural anaesthesia.
One of the main advantages of the procedure is the absence of an irritating tube in the throat (used for anaesthesia) for the patient.
According to Kumar, another advantage is that the blood pressure variation during the surgery is reduced to minimum and patient is spared the discomfort of a tube in the nose and throat. The intensive care unit stay is minimized.
However, he cautioned that this procedure was not meant for everybody as it needs anesthetists with high degree of technical competence, vigilant care during surgery and a patient with cooperative attitude.
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