41% of cases caused psychological harm for patients
A new study has revealed that more than 300 people in the UK and Ireland have been conscious during an operation, despite being given general anaesthesia.
The research, which was led by the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland, looked at three million operations over the course of one year, with 300 people reporting they has experienced some level of awareness during surgery. Scientists have suggested that this happens in one in every 19,000 operations.
Most of the episodes were short-lived and occurred before surgery started or after operations were completed, with 41% of these cases resulting in long-term psychological harm. Although patients described a range of experiences – including panic, pain and choking – the most frightening feelings were those of paralysis and being unable to communicate. Researchers are calling for a checklist to be used at the start of operations and a nationwide approach to managing patients who have these experiences.
The experts also worked to identify factors that could influence these situations. About 90% occurred when muscle-relaxant drugs – used to help paralyse muscles during surgery – were administered in combination with other drugs that normally dampen consciousness. Researchers believe in some of these cases patients received an inappropriate balance of medication, leaving them paralysed but still aware.
Caesarean sections under general anaesthesia also came under the spotlight, with one in 670 who have c-sections using general anaesthesia experiencing some levels of awareness. This is partly due to the balance needed when achieving unconsciousness for the woman while still keeping the baby awake. Other common factors include lung and heart operations and surgery on patients who are obese, although 17 of the cases were blamed on drug errors.
Prof Tim Cook, at the Royal United Hospital in Bath, who led the research, told BBC News “For the vast majority it should be reassuring that patients report awareness so infrequently. However for a small number of patients this can be a highly distressing experience. I hope this report will ensure anaesthetists pay even greater attention to preventing episodes of awareness.”