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Solution to 'Devastating' Surgical Awareness Remains Elusive

Cheryl Clark, for HealthLeaders Media, August 25, 2011

"I tried to tell my body to wake up, but I could not move, I could not open my eyes...remembered gagging feeling, like I could not breathe," recalled Patient 105, the documents say.  At the end, she told the anesthesiologist "I felt every...[expletive deleted]...thing you did. I was awake the whole time."

The problem was a malfunctioning anesthesia machine that was not replaced, despite concern expressed by an anesthesiologist who reportedly questioned its functionality several days before, state documents say.

"The facility failed to have a system in place to ensure that anesthesia equipment that had not been functioning correctly was removed from service and not used for any further surgeries," the documents say.

Other cases surface quick with a simple Google search. Last year, a 73-year old Baptist minister reportedly committed suicide in West Virginia after feeling psychological distress after he found himself awake after his surgery, but was unable to cry out.

Yes, it's horrifying whenever it happens, which could be between 20,000 to 40,000 patients a year in the U.S., or as high as 1% of those who, for a variety of reasons are at greater risk, published studies say.

"How often it happens is a tough question," Jeffrey Apfelbaum, MD, Chairman of the American Society of Anesthesiologists Standards and Practice Parameters Committee, acknowledged. They are extremely rare, although "we know not all of them are reported," he said.

He emphasized that such cases, where a patient has complete or partial unintended awareness during a surgical procedure, "is a devastating complication, and one that can be associated with post-traumatic stress syndrome" years later.

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