Many people’s biggest nightmare is the thought of waking up during an invasive surgery. How often does this actually happen?

BBC news reports on new information showing that it is actually fairly common for people to wake up during surgeries. Hundreds of people report that they have been awake during major surgeries despite being given anesthesia.

How often does this happen?

“In the largest study of its kind, scientists suggest this happens in one in every 19,000 operations. They found episodes were more likely when women were given general anesthesia for Caesarean sections or patients were given certain drugs. Experts say though rare, much more needs to be done to prevent such cases,” according to the BBC.

What are the consequences of waking up during surgery?

Most patients faced extreme anxiety and a gagging feeling. The study was led by the Royal College of Anesthetists and Association of Anesthetists of Great Britain and Ireland. The researchers analyzed three million operations over a period of one year.

What were the results?

Over 300 people reported they had experienced some level of awareness during surgery. A portion of them actually remembered experiences from years ago. Many episodes were short-lived and happened before surgery started or after operations were done. However around 41% of cases resulted in long-term psychological harm. Numerous patients displayed a myriad of experiences - from panic and pain to choking – but not all episodes caused great concern or ambivalence.

Which things scared patients the most? BBC reports,

“The most alarming were feelings of paralysis and being unable to communicate, the researchers say. One patient, who wishes to remain anonymous, described her experiences of routine orthodontic surgery at the age of 12. She said: ‘I could hear voices around me and I realized with horror that I had woken up in the middle of the operation but couldn't move a muscle. While they fiddled, I frantically tried to decide whether I was about to die’.”

What were the consequences of being awake during surgery?

Many patients report experiencing much trauma afterwards.

One patient “Told researchers that for 15 years after her operation she had had nightmares of monsters leaping out to paralyze her. And it was only after she made the connection between this and her operation that the nightmares stopped. Each person's experience was analyzed to identify factors that could make these situations more likely. About 90% occurred when muscle-relaxant drugs - used to help paralyze muscles during surgery - were administered in combination with other drugs that normally dampen consciousness,” according to BBC.

How do they end up staying awake?

Experts believe that in some of these cases patients were administered a wrongful balance of medication, leaving them paralyzed but still aware. In addition there were numerous reports of awareness from women who had Caesarean sections while under general anesthesia. Despite the fact that this type of anesthesia is usually utilized in emergency situations, researchers say women should be told of the risks and dangers.

In how many cases were drugs administered inappropriately? Researchers said, “They calculate up to one in 670 people who have Caesarean sections with general anesthesia could experience some levels of awareness. But experts argue this is partly due to the balance needed when achieving unconsciousness for the woman while still keeping the baby awake. Other common factors include lung and heart operations and surgery on patients who are obese. And some 17 cases were due to drug errors.”

How can these errors be prevented?

There are many simple things physicians should be doing to deter these types of errors. Experts are saying there should be a checklist to be utilized at the beginning of operations to make sure that everything is administered properly and all precautions have been taken. Researchers are also saying there should be a nationwide approach to managing patients who have these experiences and problems.

Professor Cook who led the research told the BBC, “For the vast majority it should be reassuring that patients report awareness so infrequently. However for a small number of patients this can be a highly distressing experience. I hope this report will ensure anesthetists pay even greater attention to preventing episodes of awareness.”

Gerry Oginski
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