Anesthesia is administered to keep patients comfortable and pain-free during surgeries and medical procedures. But what would happen if you were to wake up during surgery? Although anesthesia is often effective when administered with care and precision, it can carry huge risks if not delivered correctly. One of the critical roles during surgery is that of an anesthesiologist. These specialists exist to properly administer and monitor a patient during a procedure that involves anesthesia.
A medical error by an anesthesiologist can lead to catastrophic consequences like severe pain, long-term psychological problems, and in some cases, even death. But, in Ohio, can you bring a medical malpractice lawsuit if you wake up during surgery?
The answer is not a clear as one might think. There are four main types of anesthesia. General anesthesia is used mainly for major operations. Oftentimes, surgeries requiring general anesthesia are longer procedures, ones that could result in significant blood loss, or ones that could affect your breathing during the process.
Sedation is a common form of pain control and is usually administered for less invasive procedures. These are commonly used during childbirth, bladder operations and hip replacements. You may also be given a sedative — which produces a relaxed, sleepy state but does not fully eliminate your awareness. General anaesthesia, in contrast, aims to do just that, creating an unresponsive drug-induced coma or controlled unconsciousness that is deeper and more detached from reality even than sleep, with no memories of any events during that period.
These chemicals turn up or turn down the activity of neurons, particularly the widespread communication between different brain regions. Propofol, for instance — a milky-white fluid used in general anaesthetics and some types of sedation — seems to amplify the effects of GABA, an inhibitor that damps down activity in certain areas of the brain, as well as communication between them. These areas include the frontal and parietal regions, at the front and towards the back of the head.
In the clinic, there are many complicating factors to consider, of course. Many procedures also use muscle relaxants. For example, nearly half of general anaesthetics administered in the UK included neuromuscular blockers. These drugs temporarily paralyse the body, preventing spasms and reflexes that could interfere with the surgery, without raising the dose of the anaesthetic drugs to dangerously high levels.
Neuromuscular blockers can also ease the insertion of a tube through the windpipe, which can be used to ensure the airway remains open as well as to deliver oxygen and drugs, and to prevent stomach acid from entering the lungs. This all makes anaesthesia as much art as science, and in the vast majority of cases, it works astonishingly well. But as with any medical procedure, there can be complicating factors. In some situations, you might be able to raise or lower your limb, or even speak, to show the anaesthetic is not working before the surgeon picks up their scalpel.
The unfortunate result is that a small proportion of people may lie awake for part or all of their surgery without any ability to signal their distress. Donna tells me about her own experience, during a lengthy telephone conversation from her home in Canada. She says that she had felt anxious in the run-up to the operation, but she had had general anaesthetic before without any serious problems. She was wheeled into the operating theatre, placed on the operating table, and received the first dose of anaesthesia.
When she woke up, she could hear the nurses buzzing around the table, and she felt someone scrubbing at her abdomen — but she assumed that the operation was over and they were just clearing up. The next thing she knew, she felt the blade of his knife against her belly as he made his first incision, leading to excruciating pain. She tried to sit up and to speak — but thanks to a neuromuscular blocker, her body was paralysed.
There was just nothing I could do. The frustration was immense. Eventually, she tried to focus all her attention on moving one foot, which she managed to wiggle very slightly — and felt astonishing relief when one of the nurses placed his hand over it. Before she could move it again, however, the nurse had let go. She tried a total of three times, all with the same result. But as the neuromuscular blockers began to wear off, she started to move her tongue around the tube stuck down her throat; it was a way, she thought, of signalling to the staff that she was awake.
Unfortunately, the staff misread her attempts at communication, and began to withdraw the tube prematurely, before the paralytic agent had faded enough for her lungs to be able to operate on their own. She assumed she would die. At this point, the operating room began to feel more distant, as she felt her mind escape in an out-of-body experience. A committed Christian, she says she felt the presence of God with her. It was only after the staff restored her oxygen supply that she drifted back into the operating room, to wake, crying.
That pain, the fear, the sense of absolute helplessness all still linger to this day — feelings of trauma that have led her to be put on medical leave from her job. And that has meant a loss of independence and confidence, and the abandonment of many of the hopes and dreams that she had built with her husband.
Founded in , it has now collected more than reports — most from North America — and although these reports are confidential, some details have been published , and they make illuminating reading. They seemed to be panicking. But, approximately 10 minutes later, Penner woke up.
I wanted to scream. I tried to scream. While completing his residency in Texas, Bullard had a female patient wake up. She now encourages his colleagues and their patients to have honest and open discussions. She also has pre-op advice for any patient going under general anesthesia:.
Penner now tells her story to medical students to teach them about anesthesia awareness. Penner says she went into distress on the table. Penner believes she actually had an out-of-body experience.
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