What Happens if I Wake Up During Surgery?

Many patients worry about waking up during surgery. This complication is known as anesthesia awareness or intraoperative awareness. However, with advanced monitoring and modern anesthesia techniques, it is a rare event.

What is Anesthesia Awareness?

Anesthesia awareness happens when a patient becomes conscious during surgery. This can mean hearing conversations, feeling pressure or pain (in rare cases), or not being able to move. Most of the time patients only recall brief sensations or sounds. Patients are also more likely to remember anesthesia awareness several days after surgery than immediately afterward.

How Common is Anesthesia Awareness?

Anesthesia awareness is estimated to happen in only 1 or 2 out of 1,000 surgeries where general anesthesia is used. It is more common with certain surgeries like heart surgery or C-sections where lighter sedation is necessary to minimize complications. The patient’s health and other factors also play a role.

Causes of Anesthesia Awareness.

Anesthesia awareness occurs when the anesthesia is not strong enough to keep a patient fully unconscious during surgery. This can happen for several reasons, including:

1. Use of Muscle Relaxers: Muscle relaxers are often used during surgery to prevent movement and assist with placing a breathing tube. However, they can sometimes make it harder for anesthesia providers to notice if a patient is conscious.
2. Type of Surgery: Certain surgeries, like heart or emergency surgeries, have a higher risk of awareness. This is because anesthesia providers may need to use lighter anesthesia to maintain stable heart and lung function and reduce the risk of complications.
3. Patient Health: Patients with heart disease, respiratory problems, or other medical conditions may not tolerate deep anesthesia well.
4. Other Patient Factors: Patients with chronic pain or a history of substance abuse (especially alcohol or opioids) may be less sensitive to anesthetics. This is also true for patients who have had anesthesia awareness before.
5. Technical Issues: Equipment malfunctions or monitoring problems can result in not enough anesthesia.

Preventing Anesthesia Awareness.

Anesthesia providers take several steps to prevent patients from waking up during surgery:

• Pre-Surgery Check: Before surgery, the anesthesia provider reviews the patient’s medical history, current medications, and any past experiences with anesthesia. This helps them plan the right type and amount of anesthesia.
• Advanced Monitoring: During surgery, special monitors track vital signs and brain activity to ensure patients remain unconscious.
• Customized Anesthesia Plan: Anesthesia isn’t the same for everyone. The anesthesia provider adjusts the dosage and combination of drugs to fit each patient’s specific needs.

What Should You Do if You Experience Anesthesia Awareness?

If you believe you were aware during surgery, it’s important to tell your medical team right away. They can help you understand what happened and provide support. The incident can also be noted in your medical records to prevent future recurrence.

Anesthesia awareness can be deeply distressing for some patients. Speaking with a counselor can help manage any fear or anxiety that may arise.