What is "awareness" under anesthesia?
Awareness under general anesthesia means becoming conscious – or awake – during some part of your operation and remembering things that happened. Awareness is an uncommon complication that may or may not be accompanied by pain. When using local or regional anesthesia with sedation, it is expected that patients may have some recollection of the procedure. The remote possibility of awareness should not deter you from having needed surgery. Your anesthesia professional can help you to feel comfortable and informed about your upcoming experience with anesthesia.
What causes anesthesia awareness?
Awareness occurs when you are not receiving enough anesthetic medication to keep you unconscious. Some people may react differently to the same level or type of anesthesia. Sometimes different medications can mask important signs that anesthesia professionals monitor to help assess the depth of anesthesia. In some situations, such as emergency, trauma and cardiac surgery, or in situations involving patients whose condition is unstable, the medical condition of the patient may prevent the anesthesia professional from using sufficient anesthesia to prevent awareness. Because anesthesia has certain effects on the body, including lowering blood pressure and slowing breathing, a deep anesthetic may not be in the best interest of the patient. In these and other situations – such as emergency cesarean delivery - awareness may not be completely avoidable. Awareness also may happen if the equipment that delivers the anesthetic to your body malfunctions, or if your anesthesia professional misjudges the amount of medication needed to keep you unconscious.
Can anesthesia awareness be prevented?
Before surgery, you should meet with your anesthesia professional to discuss anesthesia options and determine the plan for your operation. You should describe any problems you may have experienced with previous anesthetics, and also discuss any prescription medications or over-the-counter medications you are taking. Should you have concerns regarding awareness, before surgery is the ideal time to express them and to ask questions.
Your anesthesia professional cares for you during surgery by relying on his or her clinical experience, training and judgment combined with safe medications and continuous monitoring. During general anesthesia, your anesthesia professional will use multiple ways to determine if you are getting sufficient amount of anesthetic medication to keep you unconscious. This can be difficult in some patients. Recently, the introduction of brain monitors – like the BIS monitor – has provided anesthesia professionals with another method to help care for their patients.
What do I do if I had awareness under anesthesia?
If you have distinct recollections of your surgery after general anesthesia, you should discuss it with one of the people involved in your care. Any of the nurses who care for you, your surgeon or your anesthesia professional will be a good place to start. Sometimes, patients will not remember being awake during surgery for several days. If this happens to you, be sure to mention it to your surgeon at next appointment or if the hospital calls you for follow-up check. Regardless of whom you first mention your experience to, it is important to try to speak directly with the anesthesia professional who was involved in your surgery. Your anesthesia professional can best explain to you the events that took place in the operating room at any stage of your surgery and why you might have been aware at certain times. If your recollections of surgery or the awareness episode distresses you, your anesthesia professional can help you or refer you to a counselor or to other appropriate resources.
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