Does Brain Monitoring Prevent Anesthesia Awareness?

June 1, 2008

Studies suggest that one or two people in every thousand who undergo general anesthesia experience awareness during the procedure, maybe more in children. The Joint Commission, which inspects hospitals in the US, has made awareness during general anesthesia a “sentinel event.” (If you’re a hospital, a practitioner, or a patient, you definitely want to avoid these). The movie “Awake” and various TV programs have dramatized the issue of awareness.

The victims of awareness tell us the experience can be excruciating. Fortunately, most individuals do not experience physical pain but there is the possibility of later developing debilitating post-traumatic stress disorder. (A study of seven children confirmed to have had awareness found none of them had PTSD or any other troubling psychological problems a year later. This does not establish that PTSD does not occur in children who have had awareness but does suggest that long term problems, at least in children, are far from inevitable).

Can awareness be prevented with brain monitoring technology? An important new NEJM study looks at this.

EEG image (Wikipedia commons) Read the rest of this entry »


“I could not breathe in the recovery room”

February 17, 2008

What could be more frightening that being awake but paralysed and unable to breathe? No, I’m not talking about “Awake”, the scientifically inaccurate recent movie that dramatizes the rare but distressing experience of being awake in the middle of surgery. Rather, I am referring to the equally upsetting events that sometimes occur during recovery from general anesthesia.

Here is a vivid description, sent to a forum on the excellent consumer health site NetWellness, where I field questions about anesthesia:

“I have just had my ovaries and tubes removed because of my family history. When I woke in the recovery room, I had the most terrible experience of my life. My eyes were open, but I could not move or breath. No air would go in or out, I could not raise my arms in distress or do anything to raise the alarm that I could not breath, only stare into the eyes of the nurse. I thought, any minute now I am going to die, It was so distressing, I have been having flash backs ever since.” Read the rest of this entry »