VIDEO: Waking Up During Surgery!

All surgeries are scary or at least worrisome!

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The simple idea of someone – even a trained professional – cutting into your skin, into your flesh and just… doing stuff inside your body is a bit strange, no matter how far modern medicine has come. But can you even image how terrifying it would be to wake up during surgery?! Because yes, that happens and it has a name. It’s called anesthesia awareness.

According to Wikipedia, anesthesia awareness, also referred to as accidental awareness during general anaesthesia or unintended intra-operative awareness, is a potential complication occurring during general anesthesia where the intended state of complete unconsciousness is not maintained throughout the whole procedure.

It can occur either because of failure to deliver sufficient anesthetic medication to the patient’s body, or because of individual patient factors that mean the patient is resistant to what would normally be an adequate dose of anesthetic medication.

The most traumatic case of anesthesia awareness is full consciousness during surgery with pain and explicit recall of intraoperative events. In less severe cases, patients may have only poor recollection of conversations, events, pain, pressure, or difficulty in breathing.

Some cases of difficulty in breathing are caused by intubation errors and/or problems with the ventilator and a patient might be suffocating.

The experiences of patients who have experienced anesthesia awareness vary widely depending on why they became aware, whether they were paralyzed and patient responses and sequelae vary widely as well.

It is unusual for someone having experienced awareness without pain or suffocation to suffer bad sequelae. The experience may be extremely traumatic for the patient or not at all depending on whether they could breathe and what errors were made.

Because the medical staff may not know if a person is unconscious or not, it has been suggested that the staff maintain the professional conduct that would be appropriate for a conscious patient.

The incidence of anesthesia awareness is higher and has more serious sequelae when muscle relaxants or neuromuscular-blocking drugs are used. This is because without relaxant the patient will move and the anesthesiologist will deepen the anesthesia.

One study has indicated this phenomenon occurs in about 1 or 2 per 1000 patients or 0.13%.

Post operative interview by an anesthetist is common practice to elucidate if awareness occurred in the case. If awareness is reported a case review is immediately performed to identify machine, medication, or operator error.

Patients who experience full awareness with explicit recall may have suffered an enormous trauma. Some patients experience post traumatic stress disorder, leading to long-lasting after-effects such as nightmares, night terrors, flashbacks, insomnia, and in some cases even suicide. Some cases of awareness alert the patient to intra-operative errors.

A study from Sweden in 2002 attempted to follow up 18 patients for approximately 2 years after having been previously diagnosed with awareness under anesthesia. Four of the nine interviewed patients were still severely disabled due to psychiatric/psychological after-effects.

All of these patients had experienced anxiety during the period of awareness, but only one had stated feeling pain. Another three patients had less severe, transient mental symptoms, although they could cope with these in daily life. Two patients denied any lasting effects from their awareness episode.