Patients often remember surgery, suffer afterwards
Nearly two-thirds of anesthesiologists report encountering patients who remembered events during surgery under a general anesthetic, according to a researcher at the annual meeting of the American Society of Anesthesiologists held recently in San Diego.
Anesthesiologists call the problem "breakthrough awareness," notes Charles H. McLeskey, MD, professor and chairman of the department of anesthesiology at Scott & White Hospital and Clinic at the Texas A&M University Health Science Center in College Station, TX. It can cause nightmares, depression, fear of future surgery, and possibly malpractice suits alleging emotional distress.
About half of all surgical patients fear not being adequately sedated during the procedure, McLeskey says. The fear often is dismissed with a reassurance about general anesthetic, but recent research suggests that the patients' fears often come true.
"Studies have found that patients may not always report being conscious during surgery, and it seems that patients and physicians usually do not talk about the problems that postoperative memories may cause," McLeskey says. "The more we recognize that breakthrough awareness can occur, the more we can take steps to prevent it."
Some patients remember remarks made during surgery, and some even can recall sensations of pain or paralysis, he says. Breakthrough awareness can be caused by many factors, including a malfunction in the machine regulating the anesthetics, intentional underdosing when higher doses could be dangerous, or when the patient's anesthetic needs are underestimated.
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