British surgeons have performed their first heart bypass operations on patients who were awake, and even chatting. The patients at Harefield Hospital were all given epidural injections in the back which numb the body but do not cause unconsciousness.

The procedure is a vital step for people who may not be well enough to have a general anaesthetic. Doctors say recovery time is swifter, though the British Heart Foundation warned that large-scale trials were still needed to test the effectiveness of the procedure.

The first operation - a single bypass, using the keyhole procedure - was performed on 73-year-old John Phillipson, from Watford, on Thursday last week. "Right after the operation I felt terrific," he said. "Next, day I really felt good."

Mohamed Amrani, consultant cardiac surgeon, and his team later used the technique on three other patients at the west London hospital. "The level of the patients' consciousness during the operation and their recovery time, have been very impressive," Mr Amrani said. "Our first patient, who was operated on in the morning, was sitting up in bed, eating and reading the newspaper by the afternoon."

The technique was pioneered in Turkey and has been used in the United States and Germany, but the operations at Harefield were the first coronary artery bypass grafts in the UK using an epidural. The injections are commonly given to women undergoing a caesarean section and the dosages were similar for the heart bypasses.

Alison Shaw, a cardiac nurse with the British Heart Foundation, said: "This new technique is a positive step forward for a limited number of patients.

"But larger randomised controlled trials will be needed before epidural anaesthesia can be used in place of other established surgical procedures for coronary artery bypass surgery."