April 16, 2007
Awareness under General Anesthesia:
When surgical patients can recall their surroundings
or an event – sometimes even pain – related to their surgery
while under general anesthesia.
May also be called “anesthetic awareness” or “intraoperative awareness”
Awareness Myths & Facts
Myth: I hear that it is rather common for patients to wake up unexpectedly during surgery.
Fact: Incidents of awareness under general anesthesia are actually quite uncommon. 99.9 percent of patients under general anesthesia are completely unaware.
Myth: No one knows why or when awareness may occur.
Fact: It is known that awareness may not be completely avoidable in some high-risk surgeries, such as trauma, cardiac surgery, emergency caesarean delivery, or in other critical or emergency situations involving patients whose condition is unstable, and using a deeper anesthetic may not be in their best interest.
Myth: I’ve heard there is no way to help minimize the possibility of awareness.
Fact: Before surgery, patients should meet with their anesthesiologist if possible to discuss their anesthesia options. They can express their concerns, ask questions and share any problems they may have experienced with previous anesthetics. They should also discuss any prescription or over-the-counter medications they are taking.
Anesthesiologists are highly skilled physicians who closely monitor their patients and do everything possible to ensure that the safest and best care is provided. They are also in the process of evaluating the effectiveness of various technologies and techniques to decrease the likelihood of this occurring, and leading research into the effects of various anesthetic drugs on the brain.
Myth: I’ve been told that people who experience awareness are traumatized for life and have nowhere to turn for help.
Fact: Anesthesiologists recognize that awareness under general anesthesia can be distressing even though it is often fleeting and not traumatic to the patient. They consider any case of awareness to be important. Any patient who thinks he or she has experienced awareness should talk with his/her anesthesiologist, who can explain why he/she might have been aware at certain times.
If a patient has distinct recollections of his/her surgery and wants to discuss them, their anesthesiologist can help them or refer them to a counselor or other appropriate resources. It has been shown that early counseling after an episode of awareness can help to lessen feelings of confusion, stress or trauma associated with the experience.
Myth: I think I recently experienced awareness—maybe I should be worried. It was during a colonoscopy, and I was asleep for most of it, but I do remember a few moments.
Fact: Many procedures are performed under sedation, which is not the same as general anesthesia. Other procedures are performed using regional anesthesia, which blocks the pain to a specific area of the body. It is expected and normal that the patient will be aware for all or part of the procedure. Therefore the patient has not experienced “anesthetic awareness.” Although patients often sleep through procedures while under sedation, it should not be expected.
http://www.rmgh.net/component/option,com_docman/task,doc_download/gid,42/Itemid,26/
Myth: Patients who wake up in the middle of their surgery often feel every cut and stitch.
Fact: Although there have been a few cases in which patients have reported being awake for significant portions of their surgery, this is exceedingly rare. Remember, only a very small percentage of patients are aware of even a moment of their surgery. Reports are more likely to involve hearing conversation or other sounds for a few seconds, or being aware of the breathing tube being placed in their throat or removed at the end of surgery.
