Waking During General Anesthesia Surgery or Operation

Author: Deutsches Aerzteblatt International - Contact: aerzteblatt.de/int
Published: 2011/01/21 - Updated: 2022/06/25
Peer-Reviewed: N/A
On This Page: Summary - Main Article - About/Author

Synopsis: Cesarean sections and emergency operations carry a higher risk of awareness during surgery, and procedures at night have a higher risk than those during the day. An inadequate depth of anesthesia is the usual culprit in cases of unintended awareness during an operation. Long-term painkillers or misuse of medication can also make patients more liable to this kind of experience.


General Anesthesia
General anesthesia is a combination of medications that put you in a sleep-like state before surgery or other medical procedure. Under general anesthesia, you don't feel pain because you're completely unconscious. General anesthesia usually uses a combination of intravenous drugs and inhaled gasses (anesthetics). An anesthesiologist is a specially trained doctor who specializes in anesthesia. While under anesthesia, the anesthesiologist monitors your body's vital functions and manages your breathing.

Main Digest

Out of every 1000 patients, one or two wake up during their operation. Unintended awareness in the patient is thus classified as an occasional complication of anesthesia - but being aware of things happening during the operation, and being able to recall them later, can leave a patient with long-term psychological trauma.

How to avoid such awareness events and what treatment is available for a patient who does experience awareness is the subject of a report by Petra Bischoff of the Ruhr University in Bochum and Ingrid Rundshagen of the Charite Berlin in the current issue of Deutsches Arzteblatt International (Dtsch Arztebl Int 2011; 108(1-2): 1-7).

The usual culprit in cases of unintended awareness during an operation is an inadequate depth of anesthesia.

Several risk factors also exist that promote awareness events.

Children have eight to ten times the risk of being aware under anesthesia.

Long-term painkillers or medication misuse can also make patients more liable to this kind of experience.

The nature of the operation and the surrounding circumstances can also play a part.

Cesarean sections and emergency operations carry a higher risk of awareness than other kinds of surgery, and operations at night are higher than those carried out during the day.

For prevention of awareness during anesthesia, the authors recommend taking into account the risk factors that have been mentioned and raising the level of vigilance among medical personnel for awareness phenomena through regular training sessions.

Pre-medication with benzodiazepines and not using muscle relaxants are worthwhile measures.

Additionally, it is important to measure the anesthetic gas concentrations regularly and monitor brain electrical activity by EEG.

If possible, the patient should be given hearing protection. If a post-traumatic stress disorder does occur, the prognosis is good if professional treatment is started without delay.


This quality-reviewed article relating to our Surgery and Operations section was selected for publishing by the editors of Disabled World due to its likely interest to our disability community readers. Though the content may have been edited for style, clarity, or length, the article "Waking During General Anesthesia Surgery or Operation" was originally written by Deutsches Aerzteblatt International, and published by Disabled-World.com on 2011/01/21 (Updated: 2022/06/25). Should you require further information or clarification, Deutsches Aerzteblatt International can be contacted at aerzteblatt.de/int. Disabled World makes no warranties or representations in connection therewith.


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