Would you choose

Many of us dread the thought of being put to sleep for an operation but now there is an alternative to a general anaesthetic, writes LAURA MILNE

IT WASN’T until she was being woken up two or three times during the night and could no longer get dressed by herself in the morning that Helen Hogan realised it was time to do something about the debilitating pain in her shoulder.

The 48-year-old teacher from south-east London had put up with discomfort for several years before she opted for surgery.

“I was very nervous about the prospect of having a general anaesthetic,” she explains. “For some reason I was absolutely convinced that I wouldn’t wake up after the operation. I’d never had surgery or anything like that before.”

Fortunately for Helen, her orthopaedic surgeon, Professor Tony Kochhar, has pioneered an innovative technique which allows patients to remain fully awake during their operation.

“The advantages of carrying out surgery while the patient is awake include reduced risks and complications, especially with regards to the anaesthetic,” explains Professor Kochhar, who is based at London Bridge Hospital and specialises in shoulder and arm surgery.

“This means elderly patients and those with other medical problems can be treated where previously they could not.

“There is almost no post-op nausea or vomiting. This is one of the big concerns for patients who may have had a problem before. The operation itself is often not the issue but patients can feel terribly unwell or sick for days after a general anaesthetic, which has been previously required for upper limb surgery,” he adds.

Shoulder disorders are fairly common, according to NHS Choices. About three in 10 adults are affected by them at any one time.

Frozen shoulder, rotator cuff disorders and osteoarthritis are most common in middle-aged and older people. Shoulder instability and acromioclavicular joint disorders tend to affect younger people, particularly those who play sports that involve repetitive shoulder movements such as cricket, or contact sports such as rugby.

In Helen’s case she had acute calcific tendonitis which occurs when tiny calcium crystals are deposited on tendons causing sudden attacks of painful inflammation around the affected joint.

“It had gradually become more painful over time,” she says. “I had physiotherapy for a few months but it didn’t really help. So when Professor Kochhar explained that there was an alternative to having a general anaesthetic, I felt a lot more comfortable with the prospect of having surgery.”

Unlike a general anaesthetic which works by making the patient ‘sleep’, a local anaesthetic allows patients to remain conscious throughout the operation. The area is numbed with an injection similar to those given during routine dental procedures, which blocks the pain receptors between that part of the body and the brain.

BOTH types of anaesthetic can have some negative side effects. Local anaesthetic can cause drowsiness, slurred speech and in rare occasions, seizures.

The risks associated with general anaesthesia range from the mild – nausea, dizziness and blurred vision – to more severe, including cardiac arrest and respiratory problems.

Shoulder and upper limb surgery general anaesthetics tend to be “heavy” which is why