Anesthesia awareness

Anesthesia awareness, also known as intra-operative awareness (IOA), is a phenomenon in which anesthesia procedure is botched, thereby resulting in the awareness of the patient during the surgical procedure. Anesthesia awareness usually occurs during general anesthesia, an anesthesia in which a combination of medications are administered: a muscle relaxant, an opiate and a sedative. The experience is often traumatizing because the patient is usually unable communicate his or her distress due to the paralyzing properties of the anesthesia . Although much is not known about this phenomenon, it is thought that many cases of anesthesia awareness are attributed to human error; the remaining minority of cases are thought to be a consequence of a tolerance to the drugs, either a predisposed tolerance or a tolerence induced by the interection of other drugs. In respect to cases caused by human error, the causal errors can range from improper dosage, inadequate monitoring and shortages of drugs in the anaesthetic machines.

The prevalence of anesthesia awareness ranges from 0.1% to 0.2 %. While these percentages may seem minute, it is actually quite significant when considering the estimated 20 million surgeries that are undergone each year. The effects usually extend further than the anesthesia awareness itself. Many victims experience perpetuating after-effects known as post-traumatic stress disorder (PTSD), which is symptomatic of nightmares, flashbacks, insomnia, and is also highly comorbid with alcoholism.

Anesthesiologists and the medical community in general are accused of under-reporting incidences and inadequately educating patients and other doctors of anesthesia awareness. As in the case of Carol Weihrer, an activist and victim, the doctors ignored her post-operative complaints and the hospital did not offer counseling.

As an additional preventative measure, some hospitals use a controversial device called a bispectral index monitor. The device works by monitoring brain activity. The hypothesis is that when a person is conscious during surgery, brain activity increases. The results, however, are inconclusive as of yet. Victims of anesthesia awareness contend that if such a device only prevents a few incidences, it has fulfilled its purpose.