The technical terms vary from “awareness during anesthesia”, “recall during anesthesia”, “explicit awareness” or “unintended intraoperative awareness” but according to the U.S. National Library of Medicine, patients who have experienced this intraoperative awareness describe it as the “worst thing they have ever suffered from.”
The American Society of Anesthesiologists (ASA) defines “awareness during anesthesia” as the “unintentional consciousness or awareness of events happening during an operation either with or without pain sensations.” Simply put, it is the post-operative recall of intraoperative events. In many of these instances, a sedated person may not be able to physically notify the doctors or nurses of awareness during the surgery, but might be able to hear conversations, statements as well as experience other sensations related to the operation.
In the most traumatic cases of anesthesia awareness, the patient experiences full consciousness during surgery with pain and explicit recall of intraoperative events. In less severe cases, patients may have only poor recollection of conversations, events, pain, pressure, or difficulty in breathing.
While awareness during surgery can occur for a number of different reasons, in many instances it is a result of certain complications that arise at the time of surgery. Nonetheless, awareness during surgery is a very serious problem for the anesthetist and the patient and has thus garnered significant attention. Indeed, it prompted the ASA to engage in an Anesthesia Awareness Registry, a research project through the University of Washington to examine cases of the phenomenon.
It also resulted in the launch of the Anesthesia Awareness Campaign, which is a non-profit patient advocacy organization established in 1998 that seeks to educate people about the perils of waking up during surgery. The organization has spoken with about 4,000 people worldwide who have had anesthesia awareness experiences.
In addition to the advocacy and research initiatives, anesthesia awareness has also garnered significant media attention as the topic was the focal point of the 2010 CNN Health article, “Awake During Surgery: I’m In Hell” as well as the 2007 supernatural/conspiracy thriller, “Awake” and the award winning horror film, “Anesthesia.”
Such incidents are also the cause for legal claims against anesthetists. Therefore, surgeons and anesthesiologists must be aware of the risk factors, the prevention measures and the actions that must be taken after an awareness incident in order to minimize the unfortunate complications for both the patient and the doctors.
