Paralyzed and Awake During Surgery

Opening in theaters today, the thriller "Awake" is about a man who wakes up during surgery -- paralyzed and unable to communicate the pain he feels.

Though no official comprehensive studies have determined its frequency, the movie estimates that 30,000 Americans will experience some form of this condition this year. What is it and how can you prevent it from happening to you?

Below is information from the American Society of Anesthesiologists and American Association of Nurse Anesthetists.

What Does Patient Awareness Under a General Anesthetic Mean?

Awareness under general anesthetic is a rare condition that occurs when surgical patients can recall their surroundings or an event -- sometimes even pain -- related to their surgery while anesthetized. When using other kinds of anesthetic, such as local, sedation or a regional anesthetic, it is expected that patients will have some recollection of the procedure.

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How Common Is This Condition?

Though the movie "Awake" claims that 30,000 Americans will experience patient awareness this year, there are no conclusive studies on its frequency, but even one case is important to anesthesiologists and certified registered nurse anesthetists, who recognize that this can be a distressing or traumatic experience for the patient.

When Does Patient Awareness Happen?

When awareness does occur, it usually happens just before the anesthetic takes complete effect or as the patient emerges from the anesthetic. In very few instances, it may occur during the surgery itself.

Awareness can occur in high-risk surgeries, such as trauma and cardiac surgery, in which the patient's condition may not allow for a deep anesthetic to be given. In those instances, the anesthesia professional weighs the potential for awareness against the need to guard the patient's life or safety. The same is true during a Caesarean section, particularly if it is an emergency and a deep anesthetic is not best for the mother or child.

Does the Patient Feel Pain?

Patients experiencing awareness do not usually feel any pain. Some patients may experience a feeling of pressure.

Awareness can range from brief, hazy recollections to some specific awareness of your surroundings during surgery. Patients who dream during surgery, or who have some perception of their surroundings before or after surgery, may think they have experienced awareness. Such a sensation or memory does not necessarily represent actual awareness during surgery.

Despite the rarity of awareness, members of the American Society of Anesthesiologists and the American Association of Nurse Anesthetists want you to know about this possibility. These organizations have been studying this issue and are in the process of evaluating the effectiveness of various technologies and techniques to decrease the likelihood of this occurring.

Why Does Patient Awareness Happen?

In some high-risk surgeries such as trauma, cardiac surgery and emergency Caesarean delivery, or in situations involving patients whose condition is unstable, using a deep anesthetic may not be in the best interest of the patient. In these and other critical or emergency situations, awareness may not be completely avoidable.

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