Stay awake during your shoulder surgery

Have you ever talked to your surgeon during your surgery? It’s definitely a different experience and it is becoming more common. Today, I performed a full day of surgeries and most of my patients remained awake during surgery. Typically, they don’t say much. Sometimes they ask how things are going, or if it’s ok for them to move, or itch their nose. Many patients are worried that they will say something embarrassing, but truly it never happens.

I have done hand and wrist surgeries with my patients awake for years, but more recently have been doing shoulder surgeries this way also. Both of my rotator cuff repair surgeries from today were done with the patient awake and with a nerve block to numb the arm.

There are definite advantages to staying awake during surgery. First, you can avoid some of the unwanted side effects of general anesthesia, especially nausea. Second, it has been shown to be safer for rotator cuff repair surgery. Patients are actually less likely to have a medical complication during arthroscopic shoulder surgery if they stay awake.

In some instances I have even done shoulder replacements with the patient awake and with a nerve block. I would not recommend this for most people. Shoulder replacements involve a fair amount of surgical “carpentry” with saws, and mallets. For the average patient this is not an ideal experience! Typically I recommend an awake shoulder replacement only for patients that have serious lung problems who may not be medically able to have a standard general anesthesia.

Author

Brad Carofino, MD Dr. Brad Carofino is a board-certified (American Board of Orthopaedic Surgery), fellowship-trained orthopaedic surgeon who specializes in shoulder & upper extremity surgery. Dr. Carofino is an expert in shoulder replacement surgery, minimally invasive arthroscopic rotator cuff repair, and complex reconstructive procedures of the upper extremity.