Going in for a procedure or a surgery that requires anesthesia can be nerve-wracking for a host of reasons, from dealing with what likely is a fairly invasive procedure to having to deal with recovery time and possible pain management. For anyone who has never had general anesthesia, another source of worry may also focus on what it’s like to be under anesthesia. Some questions might be about whether you will feel anything or be aware of what’s happening to you while you’re under.
How does anesthesia work?
Anesthesia is designed to do four things to the body:
- Reduce or eliminate pain (analgesia)
- Cause amnesia so the patient does not remember their experience
- Cause unconsciousness
- Relax muscles
When under general anesthesia, basic functions may be impacted such as breathing, maintaining heart rate, and regulating blood pressure. These are just some of the important functions that our anesthesia team monitors and regulates. General anesthesia makes it so a person doesn’t feel any pain while out and also doesn’t remember anything from the time they were under.
What is anesthesia awareness?
Very rarely, in only about one or two of every 1,000 procedures that need general anesthesia, a person may experience what is called anesthesia awareness. That can be an upsetting situation, but patients do not typically experience any pain even if they do have a moment of awareness. Again, this is an extremely rare complication and of those who did have awareness, 0.01% percent of patients denied feeling any pain.
Why does anesthesia awareness happen?
The vast majority of patients remain completely unconscious during any procedure or operation that requires general anesthesia. However, for the very small number of people who experience anesthesia awareness, it is often due to a certain set of circumstances. One of those circumstances is if a person has multiple medical conditions that could interfere with how well anesthesia is processed by the body. Another circumstance is surgeries that happen during emergencies, such as emergency C-sections, heart surgery needed urgently, or surgery following a traumatic injury from something like a car crash or industrial accident. In those situations, the usual dose of required anesthesia often can’t be used safely, so the chances of having moments of awareness is higher.
Preventing anesthesia awareness
Anesthesia awareness prevention is taken very seriously. If you have concerns about anesthesia awareness, it is important to talk with your doctor or surgeon ahead of the surgery. Additionally, the anesthesiologist will meet with a patient ahead of a procedure to discuss your medical history and any previous issues a person has experienced with anesthesia. It is important to be honest and open about medical history and current behaviors to ensure the anesthesiologist fully understands anything that may increase the risk of anesthesia awareness. In particular, it is important to let the anesthesiologist know about:
- Any previous problems with anesthesia
- Every medication and supplement the patient is taking, including anything that is prescription or over-the-counter
- Any concerns the patient may have about waking up during anesthesia
- History of drug or alcohol use, both of which may increase the chances of anesthesia awareness occurring
What to do after experiencing anesthesia awareness
Anesthesia awareness can be a scary and even a traumatic experience. If a patient experiences awareness during a surgery or procedure, it is important to let the anesthesiologist know about what happened and what the patient recalls. The anesthesiologist can help the patient understand what might have happened at a specific moment that led to the anesthesia awareness. The anesthesiologist also can walk through the different drugs used throughout the procedure or surgery and determine if any of the drugs may have led to false memories. Anesthesiologists are always trying to collect more information about anesthesia awareness so they can find new ways to prevent it from happening. Patients who have experienced it are encouraged to report their experiences to the Anesthesia Awareness Registry, which can be found at www.awaredb.org.
If anesthesia awareness is something that is causing anxiety or stress, talking with a psychologist or mental health therapist can help the patient process those feelings and find ways to cope with any stress or confusion being felt.
Written by Sheena McFarland
