Report

Imagine this terrifying scenario:

You are in the middle of surgery when you instantly wake up as the surgeon starts to cut you open. You’re totally aware of what is happening, however you cannot move, or speak. Think this sounds unreal? It’s not. It’s a problem called Anesthesia Awareness (AA).

This scary situation is now being investigated thoroughly, attempting to fully understand the emotional damage that is inflicted on the psyche. Some medical equipment manufacturers may have found the solution.

According to The Nemours Foundation, one of the largest nonprofit organizations devoted to children's health, they write, "Think of the brain as a central computer that controls all the body's functions and the nervous system as a network that relays messages back and forth from the brain to different parts of the body. It does this via the spinal cord, which runs from the brain down through the backbone and contains threadlike nerves that branch out to every organ and body part." Basically simplifying how the complex mechanisms of our body's nervous system work. So the goal is to have the brain completely put to sleep during the procedure.

Rhonda Campbell, an eHow.com Contributor, writes “Neurons in the brain are like pushing buttons on the console to send and receive messages,” she continues, “Anesthesia keeps the nerves in your body or brain from touching buttons on the console to send and receive messages.” Explaining how the body can now be numbed from sensation. She further describes, “This is the reason that a surgeon can perform an intensive operation on your body without you feeling or recalling the operation.” Thus anesthesia is a very important — if not the most important — tool for surgical procedures.

However, in ultra-rare circumstances a patient can become aware during the procedure. Being able to fully feel what is happening, and hear what is going on around them; however, unable to move.

Anesthesiologist Mohamed M. Ghoneim, an expert on anesthesia awareness who is a professor at the University of Iowa, and colleagues write “The term “awareness” during anesthesia, as used in the anesthesia literature, implies that during a period of intended general anesthesia, the brain is aroused by stimuli that are stored in memory for future explicit recall. Patients who experience awareness will recall such experiences during a state of inadequate anesthesia,” saying that the arousal of the brain is retained in the memory for recalling it at a later time (Ghoneim 527). In nearly all situations the brain is not stimulated during the procedure, as this is extremely rare.

Having AA is very unlikely. In a study done by Ghoneim, and colleagues, they took data from 1950 (when the first case report was published) through August, 2005. While researching patients who had undergone a procedure requiring anesthesia (totaling 19,775) only 271 cases were suspected of actually having AA.

<><><> </><> </>

BIS Monitor

To combat the scary situation now, some anesthesiologists are starting to use new technologies. One of these technologies that is largely used (and accepted by many healthcare professionals), is the Bispectral Index (BIS ®) which monitors brain activity, to allow the anesthesiologist to determine the depth of consciousness. According to Philips Healthcare, a leader in manufacturing medical equipment, “BIS measurements can help clinicians formulate the precise type and optimal dosages of anesthetic or sedative medication for each patient.”

So next time you’re going in for an anesthetic procedure, make sure you ask these three simple questions:
1.       “Do you have BIS Monitors?”
2.       “Do you use BIS Monitors?”
3.       “Will you use one on me?”

According to statistics found in Andrew T. Bowdle and colleagues journal, they write that, "Assuming that approximately 20 million anesthetics are administered in the United States annually, we can expect approximately 26,000 cases to occur each year," which is 0.13% incidence.



As you can see, it is extremely rare for this to occur.



So don't let that deter you from getting the surgical procedure that you need, because every day Anesthesiologists are working harder and harder to make this a 0% rate, daily.

Works Cited:

Bowdle, Andrew T., Domino, Karen B., Gan, Tong Joo, Ghoneim, Mohamed M., Padilla, Roger E., Rampil, Ira J., Sebel, Peter S. "The Incidence of Awareness During Anesthesia: A Multicenter United States Study." Anesthesia & Analgesia Vol. 99 No. 3 September 2004 p. 833-839. Print.

Campbell, Rhonda. “The Effects of Anesthesia on the Brain” eHow.com health http://www.ehow.com/about_5072857_effects-anesthesia-brain.html web. Retrieved 26 June 2012

Ghoneim, Mohamed M., Block, Robert I., Haffarnan, Mary, Mathews, Maya J. “Awareness During Anesthesia: Risk Factors, Causes and Sequelae: A Review of Reported Cases in the Literature.” Anesthesia & Analgesia Vol. 108, No. 2 February 2009 p. 527-535. Print.
Nemours Foundation. Types of Anesthesia. http://kidshealth.org/parent/system/surgery/anesthesia_types.html# web. 26 June 2012
Philips Healthcare. “Bispectral Index (BIS®)” http://www.healthcare.philips.com/us_en/products/patient_monitoring/products/bis/index.wpd web. Retrieved 26 June 2012

https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjkj4UxQ1eY_JS9VXC6XgCQ18bsiIOZZnZcRa1H3tId-ZP0a2QC8jbj1p8ygh1mOFZw7GKphweeeTBf1CnvFjjBRKWb0WjeKQ6Af7fU1H-JGSquaNAEyBNgQzZ3wGOTwLMmTBw4G-BU_wAu/s400/Anesthesia+Awareness.jpg Retrieved 26 June 2012

http://bcrt.ca/wp-content/uploads/2009/07/bis.jpg Retrieved 26 June 2012