It’s a knockout! New technology lets patients become their own anaesthetists

Patients undergoing operations whilst awake will be able control their levels of anxiety thanks to a new project happening at Nottingham University Hospitals NHS Trust.

At the touch of a button patients will be able to administer doses of intravenous sedation for when they feel nervous on the operating table.

Whilst all this sounds frightening, the technology is designed with minimum and maximum limits of anaesthetic in place so that patients can’t under or overdose. More so, during operations an anaesthetist will remain in the operating theatre to observe patients at all times.

The aim of the project is to give patients an individual experience of surgery by putting them in control of how awake or sleepy they want to be. It’s also thought that the technology might enable swifter recovery times as patients could reduce their exposure to the drug’s side effects.

Nottingham University Hospitals NHS Trust is working with product design researchers at Nottingham Trent University (NTU) on the project. NTU has been awarded more than £376,000 by the National Institute for Health Research (NIHR) to develop the hardware and software for the project.

A study of 25 patients has taken place at the Trust to assess the concept. Results from the study show that patients were able to choose how awake or sleepy they wanted to be and that overall they needed less Propofol, compared to if an anaesthetist had controlled sedation.

The study also showed that people who felt anxious before the operation tended to use more anaesthetic at the start of an operations, whereas those who weren’t anxious to begin with used more later on.

So far the research has focussed on orthopaedic operations, including those for knee and hip replacements.

Professor Philip Breedon, who leads Nottingham Trent’s Medical Design Research Group, said: “Undergoing surgery can be a worrying experience so patients are sedated. Propofol is very effective but, like many drugs, it has side effects that can prolong recovery.

“By putting the control of drug delivery directly into a patient’s hand, less propofol can be used without compromising the patient’s comfort, which we expect will lead to swifter recovery times.”

Nottingham Trent research fellow Dr James Sprinks, who is developing the technology, said: “Because there’s no real way of knowing how anxious a person feels, anaesthetists often err on the side of caution and have to administer larger doses to ensure that operations run smoothly.

“But this technology will help ensure that patients receive more suitable doses. It will also make patients feel more in control and anaesthetists will be provided with live data on how much the patient is taking.”

Principal investigator Dr Nigel Bedforth, consultant anaesthetist at Nottingham University Hospitals NHS Trust, said: “This is a pioneering project which could have a huge impact on the way operations involving conscious patients are undertaken around the world.

“It shows that by working in collaboration can we develop new technologies and introduce new anaesthetic techniques which help improve the experience of patients undergoing surgery.”