Waking During Surgery: Monitors May Not Help


"The simplicity of the concept, together with the showcasing of patients who have had awareness… has contributed to a demand from patients for use of this technology," noted Dr. Beverley Orser, assistant professor of anaesthesia at the University of Toronto in Canada, in an editorial that accompanied the study.

A Rare Problem

But while many surgical patients worry about being awake while under the knife, doctors say this is extremely rare.

The Joint Commission, a regulatory committee that monitors safety at hospitals, reports that between 20,000 and 40,000 cases of anesthesia awareness may occur every year in the United States. The numbers sound high, but they are dwarfed by the number of people have surgical procedures in the country every year … about 21 million.

"Only 0.1 percent to 0.2 percent of patients actually have the experience," said Dr. Ronald Emerson, a neurologist at Columbia University Medical Center (CUMC).

In short, this means you have a far better chance of getting hit by a car than waking up during surgery.

"Many patients are concerned this will happen to them, but very few will experience intra-operative awareness," agreed Dr. Eric Heyer, a neuroanesthesiologist at CUMC.

And awareness during surgery may not always mean experiencing the pain of surgery. Dr. Elliot Krane, a professor of anesthesia at Stanford University School of Medicine, explained that most cases "are really the recall of memories before the full anesthetic dose had been administered prior to surgery, or are memories during emergence from anesthesia after the completion of surgery … when awareness occurs in these and other rare circumstances, it is seldom associated with pain."

So while medical technology has made many advances to keep patients safe in the operating room, it may never replace the medical training and experienced judgment of doctors.

Waking up during surgery is rare, and, as Dr Heyer put it, doctors are "doing their best to make it even rarer."

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