General anaesthetic? How about a DVD instead?

6th May 2010 - Some patients undergoing surgery at a Glasgow hospital are being asked if they want to choose a DVD to watch during their operation.

The technique has been adopted to encourage people to opt for a local anaesthetic - sometimes known as a ‘regional block’ - rather than a general anaesthetic.

Reducing anxiety

Most patients recover faster from a local rather than a general anaesthetic, but many people are worried about the sights and sounds of the operating theatre.

Dr Nick Pace, a consultant anaesthetist at NHS Greater Glasgow and Clyde came up with the idea while looking at ways of reducing patient anxiety and making the time patients spent on an operating theatre table appear to pass more quickly.

Distraction

Pace experimented with music played through headphones, but found that didn’t seem to work. The inspiration for an alternative to music came to him while talking to a friend who was about to drive from Glasgow to London with two young children. His friend was using DVD players to distract the children while they were on the motorway.

“That’s what started me thinking that maybe a DVD might be a better way of capturing a patient’s attention and reducing their anxiety,” he tells us.

Pace bought a portable DVD player and asked the hospital engineering department to design a system so that the player would be held securely about two feet above a patient as he or she lay on the operating table.

Promoting local anaesthesia

Pace is keen to promote regional anaesthesia. “I think there are advantages to regional anaesthesia over general anaesthesia,” he says.

He compares Scandanavian countries, where 95% of patients would have regional anaesthesia, to the UK figure of between about 5% and 10%. “Some people for medical reasons would be best to have a regional block and some people do not want to be asleep - so this is an option we can provide for them,” he says.

“I am probably doing about 50% of the patients now like this [and] because of the DVD they get tempted where they may not have been tempted before.”

Pace says the same system could be used during a wide range of surgical procedures, including on the foot and ankle, hand and arm and for renal access surgery. He believes other hospitals could try the same technique with very little expense.

Top Gear or fishing?

Pace offers his patients a range of DVDs to watch while they are having their operation. So what’s top of the anaesthetist’s viewing charts? Strangely enough, it’s a programme about fishing.

“I took in Top Gear, Only Fools and Horses, Blue Planet and Mama Mia - and I took in a Bob Nudd Pole Fishing DVD as well. My wife said ‘who in their right minds would want to watch that’, but that’s the most popular,” says Pace.

Claire Butterly, a 25 year old receptionist, opted to watch something a little more light-hearted when she underwent ligament surgery. She chose Rikki Fulton’s comic creation the Rev I.M Jolly. The hospital says even if a patient bursts out laughing at their favourite comic it doesn’t interfere with the surgery.

Claire told the hospital: “It is a strange experience but I felt more relaxed than I would have been under a general anaesthetic.”