Return to Transcripts main page
American Morning
Under the Knife and Wide Awake
Aired June 13, 2003 - 08:42 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, CNN ANCHOR: Time to talk some health news now. Under the knife and wide awake. More and more patients are choosing to do surgery without general anesthesia.
Dr. Sanjay Gupta is at CNN Center to tell us a little bit more about why.
Good morning.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Stay awake for this one, Daryn; this is really important.
People think about anesthesia for operations. They think about all sorts of different types of anesthesia, most commonly people being, quote, unquote, "knocked out," or put fully asleep.
Let's take a look at the different kinds of anesthesia that people most commonly think of. Local anesthesia -- that is just a little bit of numbing medication. For instance, if you're getting a mole taken off your foot or something like that. General anesthesia -- again, putting you completely out.
But there is something in between, regional anesthesia. This is when a cluster of nerves around a certain limb may be completely numbed. For instance, if you're undergoing knee surgery, or arm surgery or something like that. In addition to that, you're also given sedatives, medications to make you a little sleepy and also make you forget the things that are about to happen to you. These are medications that are becoming more and more commonly used. Some statistics say that about a third of the operations that are done nowadays being done under this regional anesthesia.
Now a lot of anesthesiologists, a lot of doctors out there, talk about using regional anesthesia quite a bit now. Hospitals becoming more and more facile with the procedure. And a lot of people say if you don't need general anesthesia, don't get it. Sometimes the general anesthetic risk can be higher than the operation itself. Although I will say the numbers in terms of risk of any of these kinds of anesthesia are very small. About four in a million of having any significant complications.
Let's take a look at some of the advantages, though, of regional anesthesia over the general anesthesia. There are all sorts of different advantages if you compare the two side by side. You avoid the general anesthetic problems, particularly that's problems that could with your heart or your lungs. A person that has those sorts of existing problems already may opt for the regional anesthesia. Patients remain in control as well. They can keep an eye on their doctors. Quicker discharge from the hospital. This is an important issue, patients getting out of the hospital quicker. That's cheaper, as well, for the hospitals. Numbness treats the pain, so that you if you actually numb that area of the leg or the arm, or wherever is being operated, the pain control may actually last longer, and then a faster recovery.
There are some disadvantages, as well. Let me just run through those really quickly. The disadvantages when it comes to this regional anesthetic really has to do with operator issues. Not a lot of people completely adept at doing this yet. People are getting better, but there can be nerve irritation. There can be nerve damage as a result of the actual procedure of injecting the anesthesia. There are be a risk of infection and bleeding. And awake patients can sometimes distract their surgeons.
There are some well-known cases of people getting regional anesthesia as of late. The most common operations are usually orthopedic type operations. Operations on the knee, arthroscopic type operations. But some of the more visual cases, recently President Clinton undergoing knee operation under a regional type anesthetic. And also Secretary of Defense Donald Rumsfeld recently undergoing an operation, as well, on his hand under regional anesthesia.
Becoming more and more common, Daryn, you don't always have to go fully asleep to have an operation -- Daryn.
KAGAN: As I understand it, just yesterday you did one on a patient who was awake, surgery on a patient, brain surgery.
GUPTA: That's right. You know, and brain surgery, operations on the brain of all types, important sometimes to do these awake, so that you can continuously examine the patient while you're doing the operation make sure they're not developing any weakness, any difficulties with their speech, any loss of sensation, things like that. So it's important. And it's sort of remarkable when I tell people that, because the only thing that really hurts the patient typically is the skin, and you can numb that up pretty well. Drilling through the bone typically does not hurt. And the brain itself does not actually hurt. And people are always surprised when I tell them that. But that organ, which supplies nervous system to the rest of the body, doesn't really have many nerve endings of its own.
KAGAN: Well, this won't hurt a bit coming from Dr. Gupta.
Sanjay, thank you.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
Aired June 13, 2003 - 08:42 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DARYN KAGAN, CNN ANCHOR: Time to talk some health news now. Under the knife and wide awake. More and more patients are choosing to do surgery without general anesthesia.
Dr. Sanjay Gupta is at CNN Center to tell us a little bit more about why.
Good morning.
DR. SANJAY GUPTA, CNN MEDICAL CORRESPONDENT: Stay awake for this one, Daryn; this is really important.
People think about anesthesia for operations. They think about all sorts of different types of anesthesia, most commonly people being, quote, unquote, "knocked out," or put fully asleep.
Let's take a look at the different kinds of anesthesia that people most commonly think of. Local anesthesia -- that is just a little bit of numbing medication. For instance, if you're getting a mole taken off your foot or something like that. General anesthesia -- again, putting you completely out.
But there is something in between, regional anesthesia. This is when a cluster of nerves around a certain limb may be completely numbed. For instance, if you're undergoing knee surgery, or arm surgery or something like that. In addition to that, you're also given sedatives, medications to make you a little sleepy and also make you forget the things that are about to happen to you. These are medications that are becoming more and more commonly used. Some statistics say that about a third of the operations that are done nowadays being done under this regional anesthesia.
Now a lot of anesthesiologists, a lot of doctors out there, talk about using regional anesthesia quite a bit now. Hospitals becoming more and more facile with the procedure. And a lot of people say if you don't need general anesthesia, don't get it. Sometimes the general anesthetic risk can be higher than the operation itself. Although I will say the numbers in terms of risk of any of these kinds of anesthesia are very small. About four in a million of having any significant complications.
Let's take a look at some of the advantages, though, of regional anesthesia over the general anesthesia. There are all sorts of different advantages if you compare the two side by side. You avoid the general anesthetic problems, particularly that's problems that could with your heart or your lungs. A person that has those sorts of existing problems already may opt for the regional anesthesia. Patients remain in control as well. They can keep an eye on their doctors. Quicker discharge from the hospital. This is an important issue, patients getting out of the hospital quicker. That's cheaper, as well, for the hospitals. Numbness treats the pain, so that you if you actually numb that area of the leg or the arm, or wherever is being operated, the pain control may actually last longer, and then a faster recovery.
There are some disadvantages, as well. Let me just run through those really quickly. The disadvantages when it comes to this regional anesthetic really has to do with operator issues. Not a lot of people completely adept at doing this yet. People are getting better, but there can be nerve irritation. There can be nerve damage as a result of the actual procedure of injecting the anesthesia. There are be a risk of infection and bleeding. And awake patients can sometimes distract their surgeons.
There are some well-known cases of people getting regional anesthesia as of late. The most common operations are usually orthopedic type operations. Operations on the knee, arthroscopic type operations. But some of the more visual cases, recently President Clinton undergoing knee operation under a regional type anesthetic. And also Secretary of Defense Donald Rumsfeld recently undergoing an operation, as well, on his hand under regional anesthesia.
Becoming more and more common, Daryn, you don't always have to go fully asleep to have an operation -- Daryn.
KAGAN: As I understand it, just yesterday you did one on a patient who was awake, surgery on a patient, brain surgery.
GUPTA: That's right. You know, and brain surgery, operations on the brain of all types, important sometimes to do these awake, so that you can continuously examine the patient while you're doing the operation make sure they're not developing any weakness, any difficulties with their speech, any loss of sensation, things like that. So it's important. And it's sort of remarkable when I tell people that, because the only thing that really hurts the patient typically is the skin, and you can numb that up pretty well. Drilling through the bone typically does not hurt. And the brain itself does not actually hurt. And people are always surprised when I tell them that. But that organ, which supplies nervous system to the rest of the body, doesn't really have many nerve endings of its own.
KAGAN: Well, this won't hurt a bit coming from Dr. Gupta.
Sanjay, thank you.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com
