You slowly open your eyes as if emerging from a dream. You hear the harsh clang of metal instruments and the echoes of voices coming from a distance. You see shadows moving across your eyes and bright lights – but you can’t speak. Then you remember. You’re in surgery, and you can’t move – but you’re acutely aware of everything that’s going on.
Harrowing isn’t it? But waking up during surgery is a reality for one of every five-hundred people who entrust their fate to a surgeon and an anesthesiologist. It doesn’t always take place in the operating room, but it can happen in the recovery room while a person is still on mechanical ventilation with a breathing tube lodged in their trachea.
What makes waking up during anesthesia more traumatic is a person may be aware but unable to move or communicate due to the paralysis from the drugs they’ve controlled by. Fortunately, despite being aware, the majority of people who wake up during surgery don’t feel pain, but most experience panic and a sense of helplessness, which may persist for years after their surgical wounds have healed. Not surprisingly, some people who wake up during anesthesia require counseling after their recovery because of post-traumatic stress symptoms. Some even resort to suicide so troubling are their nightmares and flashbacks.
What goes wrong that causes a patient to wake up during surgery? The most common cause is getting the wrong amount or type of anesthesia. Even normal amounts of anesthesia can be a problem for people who have used medications for pain for long periods of time. Long-term use of pain-killers can lead to tolerance where anesthetic agents don’t work as well as they should. Some people, particularly women, have a higher tolerance to some drugs and may require larger doses. There are also genetic variations in how the body breaks down anesthetic agents. Some herbal supplements, alcohol and other drugs can interfere with a person’s response to anesthesia.
Certain people are at greater risk for waking up during surgery. Children have a ten times greater odds of awakening during anesthesia, a particularly traumatic situation for a child, which could lead to a lifelong fear of surgery and doctors. People who have emergency surgery or Caesarian sections are also more likely to wake up during surgery. In these situations, an anesthesiologist may hesitate to use a deeper form of anesthesia due to the risks involved. People who have surgery at night are more likely to wake up than those who have their procedures done in the morning.
Is there any way to avoid this traumatic situation? People who fear waking up during surgery should discuss their concerns with their anesthesiologist. Many hospitals can now monitor brain activity during surgery, which helps them more closely track a patient’s response. It’s also important for patients to tell the anesthesiologist about all medications they’re taking prior to surgery including herbal preparations – and get procedures done at accredited hospitals with experienced staff.
Waking up during surgery is a harrowing prospect, and, fortunately, it’s not a common occurrence, but it’s one that’s life altering.
Eurekalert.org. “Awake Despite Anesthesia”
Anesthesia Awareness Campaign.