Anesthesia Awareness

Imagine undergoing surgery after being given general anesthesia. However, instead of being unconscious during the procedure, you feel the unthinkable physical pain of surgery. But, because of the paralytic drugs you had received prior to surgery, you are unable to move or shout to express what you are experiencing.

The frightening experience described above is a condition called, anesthesia awareness, or unintended intra-operative awareness. It is a condition where patients undergoing surgery are aware of parts or all of the surgical procedure.

Effects of Anesthesia Awareness
Typically, when a patient is given general anesthesia, the patient receives a combination of drugs: sleep agents that make the patient unconscious and have no memory of the surgery, painkillers, and paralytics that prevent the patient from moving. If a patient does not receive enough doses of any of these drugs, then the patient may be conscious of events during surgery or feel pain, and worse, feel pain but be unable to tell doctors.

Of those patients who experienced anesthesia awareness, 42 percent felt the pain of the operation, 94 percent experienced anxiety, and 70 percent had lasting psychological problems, such as post-traumatic stress disorder. The experience is so traumatic for some patients that some have flashbacks and panic attacks whenever they experience anything that reminds them of their ordeal.

Causes of Anesthesia Awareness
Anesthesia awareness can occur due to the anesthetist’s error. An anesthetist may provide an inadequate amount of drugs to the patient or inadequately monitor the patient. Anesthesiologists should monitor patients by checking their vital signs to make sure the patient is unconscious and not experiencing pain. Another possible cause can be an anesthesiologist’s improper use of machines. Other times, the anesthesia is lightened too soon towards the end of surgery, so that the operating room can be used for the next patient, or the anesthesia is too light because the patient is a trauma patient who could die if given too much anesthesia.

Patient’s Experience with Anesthesia Awareness
In 2002, Sidney L. Williams was undergoing open-heart surgery when he awoke and heard the bone saw cutting into his sternum. Williams could hear the doctors discussing his diseased heart, and later he felt sharp, excruciating jolts when the doctor tried to shock his heart. Williams was unable to indicate what he was feeling to doctors at the time, because he was paralyzed due to the paralytic agent and because he was intubated.

Recommendations by JCAHO
Although anesthesia awareness is a rare condition where approximately 20,000 to 40,000 patients of 21 million patients who undergo general anesthesia, become conscious during surgery, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), a quasi-governmental organization that certifies hospitals, issued an alert, trying to reduce the occurrence of anesthesia awareness. The JCAHO made several recommendations to healthcare organizations, which included the following:

• Educating clinical staff about the condition and how to manage patients who experience the condition
• Identifying patients who are at higher risk of anesthesia awareness
• Having anesthesia monitoring techniques
• Maintaining anesthesia equipment
• Providing patients with access to mental health treatments

Thank you for reading this blog. If you or a loved one has suffered an anesthesia-related complication due to medical malpractice, or experienced serious injury due to medical malpractice, contact us for a confidential consultation. If you have a question or comment, please reply to this blog or send us an e-mail.