The pain was incredible, like nothing he had ever felt in his life. Searing, crippling, excruciating, pain, as if someone were sawing through his sternum – which, it turns out, someone was. Worse, he was incapable of stopping the pain because a breathing tube kept him from speaking; paralytic drugs made him unable to move; and taped-shut eyes made it impossible to cry.
A scene from a Hollywood B-movie? No. It is the actual experience of a patient who described his ordeal on an American operating table to a Washington Post reporter. According to the article, the man is “a victim of an uncommon, largely unrecognized and often psychologicaly devastating experience known as anesthesia awareness.”
Could this happen to you? Could you wake up during surgery and be unable to let anyone know you were awake? The answer is a qualified “yes.”
Twenty million people undergo annual surgeries in the United States. Of these, at least 40,000 unexpectedly wake up. But the American Society of Anesthesiologists says that 99.9 percent of patients will not suffer “anesthetic awareness.”
Carol Weihrer thinks the Society is being disingenuous in citing this percentage. After she awoke during surgery in 1998 to remove a diseased eye, she took on the anesthiology establishment and founded the Anesthesia Awareness Campaign, Inc., whose mission is "to prevent patients (even one) from experiencing anesthesia awareness and its consequences through education, prevention, and empowerment by replacing ignorance or fear with knowledge."
She has taken her fight to numerous TV shows, magazines and newspapers. She is especially crusading for every operating room to have brain-wave or level-of-consciousness monitors. These systems analyze the patient’s brain wave pattern, translating it into depth of sedation. Several hospitals around the country have installed them.
But medical practitioners are not universally enthusiastic about the machines. They cite cost – about $400,000 to prevent a single awareness incident (Anesthesiology. 2001 Mar;94(3):520-2), or the addition of $400 to each general anesthesia procedure. They also say that no hospital can afford to have everything it wants, so if it invests in these machines, that means it will have to forego something else. Too, the effectiveness of the monitors have not been definitively established among anesthesiologists.
What can you do to assure you don’t feel every cut and stitch in your next surgical procedure? Almost everyone discusses upcoming surgery with the surgeon, but not always with the anesthesiologist. If you’re concerned about waking up during surgery, do speak in advance with your anesthesiologist, explaining any concerns you have about being aware during surgery. Discuss any problems you have had with previous anesthetics. And, of course, report any prescription or over-the-counter medications you are taking. You might also ask if they have the brain wave monitors. If the hospital does not, and if the monitors are important to you, schedule your surgery at a hospital that does have them.
Sources: “Wake-Up Call,” Washington Post, Nov. 23, 2004, www.washingtonpost.com; “Wake Up During Surgery? Chances are reduced with innovative new brain wave monitors at UW Medical Center,” University of Washington, Dec. 1, 1997, www.UWnews.org; Anesthesia Awareness Campaign, Inc., www.anethesiaawareness.com; American Society of Anesthesiologists, www.asahq.org