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    Awake During Surgery: How Rare?

    Less Than 1% of Patients Experience Anesthesia Awareness Under General Anesthesia

    Avoiding Anesthesia Awareness continued...

    They describe a fine line between too little anesthesia, which may lead to anesthesia awareness, and too much anesthesia, which may cause side effects including nausea and vomiting after surgery.

    "We are still in a situation where we have to use all of our senses and all of our knowledge," Bloom says. "At this point, there is no way to flip a switch and let the monitor tell us how much [anesthesia] to give."

    The webcast was sponsored by Stryker, which makes a brain function monitor.

    Anesthesia Awareness Advocate

    All of the doctors who took part in the webcast say they don't know of any of their patients who experienced anesthesia awareness.

    But Carol Weihrer, who experienced anesthesia awareness when she was having surgery to remove an eye, says that posttraumatic stress disorder (PTSD) is frequently reported by the thousands of anesthesia awareness patients she's talked to over the years.

    Weihrer explains that during her surgery, she got an initial dose of anesthesia but further anesthesia wasn't immediately available because, as she says, "my anesthesiologist hadn't checked his equipment."

    "My brain was as alert as it was right now," says Weihrer, calling the experience "very traumatizing." Weihrer is the president and founder of Anesthesia Awareness Campaign Inc.

    Guidry, who wasn't involved in that operation, notes that Weihrer's situation may have happened because her anesthesia wore off, not because it didn't work.

    Handling Anesthesia Awareness

    Tom McKibben, CRNA, past president of the American Association of Nurse Anesthetists, recommends that patients be asked these questions as they recover from procedures involving general anesthesia:

    • What is the last thing you remember before surgery?
    • What is the first thing you remember after surgery?
    • Do you remember anything during the procedure?
    • Did you dream during the procedure?

    He adds that in the first few weeks after general anesthesia, patients should also be asked what the worst thing was about the operation.

    "If they say the nightmares or recurring dreams [or other disturbing experiences apart from postsurgery pain] we need to follow up with that," says McKibben.

    That follow-up may include referrals for counseling to help patients cope with what Weihrer calls the "life-changing experience" of anesthesia awareness.

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