Waking Up During Surgery? OHSU Dispels Myths

01/20/11  Portland, Ore.

OHSU anesthesia experts hope to alleviate patient concerns regarding waking during surgery.

The upcoming movie “Awake” features a heart transplant patient who experiences “awareness” while under general anesthesia, which may raise concerns for some patients. Anesthesia professionals at Oregon Health & Science University would like to help dispel myths and allay potential fears in advance of the film’s release this week.

According to the American Society of Anesthesiologists (ASA), awareness during surgery is a very uncommon condition that occurs once or twice per thousand cases and usually includes mild events lasting only a few seconds.

When awareness occurs under general anesthesia, it is often just prior to the anesthetic taking effect or as the patient emerges from anesthesia. It can vary from foggy recollections of the surroundings to a specific remembrances of an event related to their surgery.

Awareness can occur during high-risk surgeries such as trauma or cardiac surgery in which the patient’s condition may not allow for a deep anesthetic to be given. In these cases, the anesthesia professional weighs the potential for awareness against the need to guard the patient’s life.

“Although the odds of experiencing awareness during surgery are extremely slight, we take every case seriously and recognize that the experience can be distressing for patients,” said Jeffrey Kirsch, M.D., professor and chairman of anesthesiology and perioperative medicine, OHSU School of Medicine, and member, American Society of Anesthesiologists (ASA).

“People react differently to the same level of anesthesia. The best way to prevent the possibility of awareness is for patients to meet with their anesthesia professional before surgery to discuss any previous problems they’ve had with anesthetics and any prescription or over-the-counter medications.”

Researchers in anesthesiology have been seeking ways to prevent the condition for years. Currently they are evaluating the effectiveness of various devices and techniques to better monitor the vital signs and brain waves of surgery patients.

“However, no technology can replace the presence of a highly trained anesthesia professional,” said Norman Cohen, M.D., assistant professor of anesthesiology and perioperative medicine, OHSU School of Medicine, and a member of the ASA board of directors. “Anesthesia professionals undergo extensive education and training to help safely guide patients through surgery, while keeping the patient as comfortable as possible. Every surgery requiring anesthesia should involve a highly trained anesthesia professional.”