Brandview / 

Wide awake surgery: What it looks like and why patients want it

Wide awake surgery: What it looks like and why patients want it

(Shutterstock)


Save Story
Leer en español

Estimated read time: 4-5 minutes

This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.

"Jen, why so quiet? … Would you like to see what we've done?"

Jen Simonds sits up and leans over a blue surgical drape to get a bird's eye view of the white, chopstick-sized tendons exposed through an incision in her wrist. She listens intently as Douglas Hutchinson, M.D.—or "Hutch"—explains how he has cut and released the ligament that's been pressing down on one of her nerves and causing pain, numbness and tingling in her left hand.

Being conscious for surgery may sound like a frightening throwback to the days before anesthesia. But the practice is taking hold as a low-risk, low-cost and patient-friendly approach to a growing number of procedures. "Most patients say, 'Oh, I can roll up my sleeve, you can inject me with a local anesthetic and do the surgery, and I can walk out of there in a matter of minutes with my coffee cup still in my hand? That's fantastic,'" says Hutchinson, chief of hand surgery at University of Utah Health Care.

If anything, it's doctors who most need convincing, Hutchinson says. Carpal tunnel surgery is a common procedure with great outcomes, low complication rates and high patient satisfaction. So, why mess with it? Why mess with success?

That was the initial response Hutchinson received from some of his colleagues when he proposed moving his carpal tunnel surgeries from the operating room to an outpatient setting. Some voiced worry that patients wouldn't tolerate the injection without sedation. Then there was the challenge of securing extra space—not to mention, disrupting the normal workflow for doctors, registration clerks and nursing staff. "Change is hard, especially when everyone's happy with the status quo, including patients," Hutchinson says.


Being conscious for surgery may sound like a frightening throwback to the days before anesthesia. But the practice is taking hold as a low-risk, low-cost and patient-friendly approach to a growing number of procedures.

But so often, innovation is about giving people what they want before they know they want it. Health care is changing and as consumers shoulder more of the cost of their care, they're becoming more discriminating about where they spend their money, says Charles Saltzman, M.D., orthopedic department chairman at the U.

Freed from having to prep patients for the operating room and monitor their recovery afterward, Hutchinson's team is now able to do more surgeries in less time and for about a third of the cost—making the scheduling of appointments more convenient for patients and sparing them the risks and side effects of anesthesia. "I didn't have to arrange transportation or take a lot of time off work," says Simonds who strategically scheduled her surgery before a holiday weekend. "The only thing I missed were a couple of meetings and office hours."

Instead of administering sedating drugs through an IV, Hutchinson numbs the wrist with an injection. Patients don't have to refrain from eating or drinking. They can carry on a conversation with Hutchinson throughout the surgery and stand up and leave immediately after.

Courtesy of University of Utah Health Care
Courtesy of University of Utah Health Care

The shift has led to other efficiencies at the hospital by freeing up operating room time for more complicated surgeries. "It just makes sense. We love it, and so do the patients," says Clark Monk, a nurse in Hutchinson's unit.

It's also better for the environment, because outpatient procedures require less equipment and produce less medical waste. "We've whittled a three-hour process down to 30 minutes, from registration to discharge," Hutchinson says. "Now I have doctors asking me if we can do other kinds of surgeries this way."

Wide awake surgery doesn't appeal to every patient, nor is it always appropriate, says Hutchinson. "If I'm doing multiple things, like carpal tunnel plus three trigger fingers, or we need a lot of x-rays, it can get tricky."

But Simonds, who reacts poorly to anesthesia, wouldn't have it any other way. Hoping to avoid surgery, the psychology professor first tried wrist splints and hand exercises but her condition worsened. Hutchinson has now operated on both of her wrists. "It has made such a difference and been such a relief," she says.

Being alert for the procedures gave her comfort and helped her feel more a part of the whole process. "I thought about becoming a doctor in elementary school, so the biology of it interests me," says Simonds. "It's low cost and low hassle, and really not much more involved than getting a filling at the dentist.

Want to learn more about carpal tunnel surgery without general anesthesia? Call 801-587-7109 or visit the University Orthopaedic Center website.

Related topics

BrandviewU of U Health
University of Utah Health Care

    STAY IN THE KNOW

    Get informative articles and interesting stories delivered to your inbox weekly. Subscribe to the KSL.com Trending 5.
    By subscribing, you acknowledge and agree to KSL.com's Terms of Use and Privacy Policy.

    KSL Weather Forecast