Surgical Nightmares: When Patients Wake During Operations

Introduction

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.

Main Digest

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.

Attribution/Source(s):

This peer reviewed publication was selected for publishing by the editors of Disabled World due to its significant relevance to the disability community. Originally authored by Deutsches Aerzteblatt International, and published on 2011/01/21 (Edit Update: 2024/07/16), the content may have been edited for style, clarity, or brevity. For further details or clarifications, Deutsches Aerzteblatt International can be contacted at aerzteblatt.de/int. NOTE: Disabled World does not provide any warranties or endorsements related to this article.

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