Bypass surgery with just local anaesthesia

AHMEDABAD: City doctors on Thursdayperformed open heart surgery under local anaesthesia - while the patient wasawake. It was the first-of-its-kind surgery in the state. Cardiac surgeon Dr Rajeev Gehlot of Rajsthan Hospital said the patient Jashoda, 45, complained of breathlessness and was diagnosed with 99% blockage in the main coronary artery as well as chronic obstructive lung disease. It was found that if the coronary artery bypass surgery is performed under general anaesthesia, her lungs would not recover and she would be dependant on mechanical ventilation even after operation. The cardiac team therefore decided to performthe operation using thoracic epidural anaesthesia, which only numbs the bodyfrom the neck to the lower thorax, instead of making the patient unconscious.Jashoda was fully conscious and could see if there were any irregularities thatoccurred during the procedure. Dr Rajeev was supported by cardiac anaesthetistDr Himanshu Shah in the surgery. "The operation was technically moredifficult as the patient was breathing on her own, and the movement of the chestwall could not be controlled. As a result, I needed to operate in a closed area.Under normal circumstances, the inflation and deflation of the lung can bemechanically controlled," said Dr Rajeev who has performed similar operations inBangalore. He said such an operation is very beneficial for thosewith chronic lung diseases or cerebral vascular diseases which can reduce bloodsupply to the brain. Even singers can undergo this kind of surgery to protecttheir vocal cords from mechanical injury which can be caused by the catheterthat is inserted into the trachea in order to anaesthetize thepatient.Jashodaben has recovered well and can even walk now as shedoes not suffer from any respiratory problems that are usually experienced aftersuch an operation. She was already told about the procedure and the precautionthat will have to be taken. She says she felt no fear, only anxiety that mostpatients feel before surgery.