Some Patients Experience Awareness Of Surgery
Posted November 24, 2003
CHAPEL HILL, N.C. — When a person undergoes surgery, they are supposed to fall asleep and wake up with no memory of what happened. That is not always the case.
"I think of the horror of having to live through that," patient Kate Adamson said. "Not being able to communicate with anyone and then wondering inside when is this going to be over? I could only endure and survive and pray that I could live through it."
What happened to Adamson happens to every two out of 1,000 people under anesthesia. Patients do not truly wake up, but experience an unexpected awareness during surgery or memory of the experience once it is over.
"There is some conscious processing of what's going on, be it pain or conversation," said Dr. Philip Boysen, an anesthesiologist at University of North Carolina Hospitals.
Boysen said it can takes weeks for patients to make the connection.
"It might not show up in conscious memory and show up as post-traumatic stress," he said.
Boysen said waking up is more of a risk now that many patients have surgery and go home the same day.
"So now you have the issue of titrating the anesthetic so they don't remember they don't have pain, but they recover much more quickly," he said.
A monitor helps doctors find that happy medium. The BIS monitor measures depth of anesthesia or how "under" a patient is. The device is not foolproof, but it does reduce the risk of waking by 80 percent.
The goal is to find the magic number where patients are pain- and memory-free.
"My hope would be that no one has to live through this experience," Adamson said.
Compared to the number of surgeries done, the problem is rare. Doctors WRAL talked with said even a few cases are too many.