Surgery Without Anesthesia

Reported November 2007

SAN DIEGO, Calif. (Ivanhoe Newswire) -- Going under the knife means going under first with anesthesia. With the side effects often associated with it, some people are choosing a more direct approach to block the pain.

For Paul Tomasini, this surgery has been a long time coming. After years of dealing with crippling arthritis in his feet, Paul is finally getting some relief. The pain was so bad Paul had trouble staying on his feet. Not good, since he owns his own contracting business. The only shoes he could wear were torn out, worn out sneakers.

“I’m on my feet most of the time. I need protective foot wear,” Tomasini told Ivanhoe.

The surgery he is having will be painful, but Paul won’t feel a thing because he is being given a nerve block.

“I like to compare it to an injection a dentist gives you before you have a cavity filled.” Edward Mariano, M.D., director or regional anesthesia at University of California San Diego, told Ivanhoe.

The anesthesiologist first uses ultra sound to locate the peripheral nerve near the surgical site.

Through a catheter, a nerve numbing medication is injected into the area, and minutes later the patient undergoes surgery without general anesthesia.

“You can breath on your own; you don’t require a breathing tube like you do with general anesthesia and after surgery your pain relief is very specific to the sight,” Dr. Mariano said.

Patients can stay awake for their surgery. In Paul's case … he caught up on some rest! He was home within a few hours. A small pump was attached to his catheter … giving him the control to add more or less pain medication directly to his foot.

“If I needed an extra dose of medicine, I would just pump this blue button," Tomasini said.

"What this allows patients to do is enjoy a better recovery in terms of having less mental confusion, less nausea, less itching," Dr. Mariano said.

The very next day, Paul was up and around ready to get back to work.

Click here to Go Inside This Science or contact:

Jackie Carr, Health Sciences
Communications & Public Affairs
UCSD Medical Center
(619) 543-6427
jcarr@ucsd.edu

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