Surgery can be an intimidating experience. However, most people believe that they are under general anesthesia and will not remember or feel any pain.
In rare cases, however, patients may become aware of the surroundings they are in during surgery. This is known as or unintentional intraoperative awareness.
It is difficult to assess awareness and responsiveness while under general anesthesia. There are many ways to measure consciousness. These include using monitoring equipment, behavioral testing, and self-reports from the patient.
Electroencephalograms (EEGs) and other monitoring equipment can be used to detect anesthesia level changes. The interpretation of EEG data is difficult, and there’s no consensus on the best way to define anesthesia levels. Monitoring equipment is expensive and not always available at all medical facilities.
The isolated forearm test, among others, has been used as a behavioral test to assess the patient’s response to verbal commands. These tests are difficult to carry out and can result in false positives or negatives. Not all patients can respond verbally to commands, particularly if they’ve been given neuromuscular blockers.
Self-reports by patients can be used to detect awareness. This method depends on the patient being able to accurately recall the event.
How often does accidental awareness occur?
The rates of accidental awakening during general anesthesia are highly variable.
Some studies have reported awareness rates of up to 1 in 25 patients. This does not mean the person is fully conscious and awake. Even if they appeared to be awake, it doesn’t necessarily mean that they are.
In studies that relied on self-reports from patients, incidence rates were much lower. Some reported as low as one in 19,600. This would be a better representation of the number of people who actually experienced wakefulness and were able to recall it afterwards.
Why does accidental awareness occur?
Accidental awareness can be caused by several factors. These include equipment failure, drug dosage errors, and patient factors like obesity or drug usage.
The anesthesia team could also have failed to properly assess the level of consciousness in the patient during the procedure.
It is important to remember that an accidental awareness of the surgery is rare. Most patients remain unaware.
What can I do to prevent waking up during surgery?
You can reduce the chances of anesthesia during surgery by taking steps to minimize risk. Here are some tips.
- Follow the instructions. Your anesthesiologist can give you detailed instructions about how to prepare for surgery. These instructions are important, as they may affect the absorption of anesthesia and its effectiveness.
- Anesthesiologists will ask important questions regarding your medical history, allergies and medications or supplements you use.
- Be honest and open with your anesthesiologist. The truth about drug and alcohol abuse can have a significant impact on the type and dosage of the anesthesia you require.
- Do not be afraid to ask about the process of anesthesia, the type and monitoring equipment used. Understand the risks and benefits associated with your procedure, as well as the type of anesthesia that will be used.
- It is important to speak up if you experience any discomfort during surgery. You should inform the anesthesia team as soon as possible. This will help to prevent the discomfort from continuing, and the team can adjust the anesthesia as needed.
You can talk to your anesthesiologist or surgical team if you’re still worried about waking during surgery.
They will provide more information on the anesthesia techniques, monitoring equipment and any other concerns that you may have.