Girgis Abadi
Background
Maximising day surgery rates for upper limb procedures requires optimising recovery and mitigating risks, particularly in patients with comorbidities who may otherwise require inpatient admission. Awake surgery under regional anaesthesia avoids general anaesthesia (GA) and facilitates rapid, safe discharge. This project evaluates the clinical effectiveness and patient experience of an awake shoulder and hand surgery.
Methods
A patient information leaflet (PIL) was developed, approved, and distributed during preoperative assessment. Patients who underwent upper limb surgery under regional anaesthesia (with or without sedation) between September 2024 and August 2025 at Milton Keynes University Hospital were identified. Of 43 patients contacted, 27 responded to a structured telephone survey. Data collected included procedural timings, type of surgery, anaesthetic technique, and patient-reported outcomes, including comfort, pain, satisfaction, and overall experience.
Results
The average anaesthesia-to-surgery time was 34 minutes. Patients received a regional block with (63%) or without (37%) sedation. While 33% did not receive the preoperative leaflet, 83% of those who utilised it felt prepared, and 66% reported reduced concerns. Intraoperatively, 92% of patients were comfortable (70% very, 22% somewhat), and the experience matched expectations for 85%. Postoperatively, there were zero complications (0/27), and 86% achieved a good night's sleep. Overall, 92% were satisfied with their care, and 85% would recommend awake surgery to others
Conclusion
Awake upper limb surgery is a safe, effective pathway with high patient satisfaction. Standardising preoperative information and developing a Standard Operating Procedure may further streamline care and enhance patient experience.
Authors
Adel Emam Amer, Milton Keynes University Hospital, Milton Keynes, United Kingdom & Frimley Health NHS Foundation Trust, Frimley, United Kingdom
Anushaprasath Uthayasingh, Milton Keynes University Hospital, Milton Keynes, United Kingdom
Alistair Lee, Milton Keynes University Hospital, Milton Keynes, United Kingdom
Anwar Rashid, Milton Keynes University Hospital, Milton Keynes, United Kingdom
Girgis Abadi, Frimley Health NHS Foundation Trust, Frimley, United Kingdom