Monday, December 03, 2007
Awake: Waking up during surgery
"My toes wouldn't move. My whole body was completely paralyzed. I had no way to let them know I was awake...I felt the doctor take my hand and I thought oh dear god, they're getting ready to cut my hand."
That's Jodie Stanley describing being awake during surgery. It's a phenomenon called anesthesia awareness. Jodie, a registered nurse, says she had never heard of it until it happened to her. Victims have called it their worst nightmare. "They may remember sounds or conversations in the operating room or they may have excruciating pain or wake up feeling paralyzed, not being able to respond. It's like being alive, but inside a corpse," according to Dr. Peter Sebel of Emory University School of Medicine.
A new movie called "Awake" just came in at No. 4 in the weekend's box office tally. The thriller stars Hayden Christensen as a patient who is fully conscious but physically paralyzed during surgery. The movie's promoters have said, "It will do for anesthesia what 'Jaws' did for swimming in the ocean."
To be clear, anesthesia is very safe, and awareness incidents are rare. Out of the 30 million cases in which anesthesia is used, anesthetic awareness happens in about 1 or 2 cases out of every 1,000 according to the American Society of Anesthesiologists.
Researchers believe that anesthesia awareness is under-reported by 50 percent to 100 percent of the official numbers, says Carol Weihrer, president and founder of the advocacy group Anesthesia Awareness. She bases her numbers on her own experience as an advocate and information she has pulled together from other organizations.
She emphasizes that whenever it does occur, the impact can be traumatic. According to her organization, approximately 50 percent of awareness victims suffer from post-traumatic stress disorder.
It's definitely a scary risk however remote, but there are certain things that can help reduce your risk of experiencing anesthesia awareness. Brain monitors can help reduce the risk by more than 80 percent, but they are available in only half of operating rooms according to Sebel.
Here are some important points you should address with your doctor before going under:
Operating room brain monitors: Are they available in your facility?
Weight: Your body mass index (BMI) or amount of body fat is a factor. Anecdotally, women and slimmer patients report more awareness.
Age: The older you are, the less anesthesia you need.
Existing disease: Your risk can change, especially with diabetes or cancer.
Medications/herbal supplements: Any medications including herbal supplements can have a big effect on the anesthesia.
Type of surgery: Some surgeries are more susceptible to awareness including cardiac and obstetric operations and acute trauma surgery.
Have you or someone you know experienced anesthesia awareness?
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