Waking up on the operating table is the stuff of TV shows and nightmares. The popular TV drama Grey’s Anatomy aired an episode where, mid-surgery, a patient under general anesthesia awoke and could smell, hear, and see what was going on without being able to move or speak. But anesthesia awareness can happen in real life, as the author of a recent article in The New York Times highlights. If you wake on the table under conscious sedation, can that be classified as medical malpractice, or just awful luck?
What Causes Anesthesia Awareness?
Anesthesiologists make careful decisions about anesthesia dosing and the type of anesthesia that is given based on a person’s current health, medical history, and the problem they’re experiencing. If a patient isn’t given enough anesthesia, they may wake mid-procedure.
If a person metabolizes an anesthetic agent too quickly, there is a risk of awakening during surgery. Pre-op testing, including diagnostics and evaluation, should identify any conditions that could affect anesthesia and allow the drug to be adjusted accordingly. However, there is unlikely to be routine testing for how a patient metabolizes anesthesia because anesthesia awareness is so rare and anesthesiologists are always in the operating room during a surgical procedure to monitor vitals and levels of consciousness.
Anesthesia awareness in conscious sedation is a different story, however, as it is used in situations where an anesthesiologist is not necessarily present and there may not be an operating room or hospital setting, such as during dental work, plastic surgery, colonoscopies, and heart rhythm corrections. Nurse anesthetists and anesthesiologist assistants often administer the anesthesia.
The cocktail that makes up conscious sedation does not have a firm definition, but includes pain control, anxiety control, and amnesia that will vary not only between patients but between the procedures done and the doctor performing the procedure. There is room for anesthesia error and room for trauma afterward, no matter how aware a patient is that they may be drowsy or even wake up during their procedure.
The Side Effects of Anesthesia Awareness
If a patient wakes during conscious sedation, they may feel no adverse effects. Some people wake and don’t even remember the incident. There are a few patients, however, who can experience a terror that leads to post-traumatic stress disorder (PTSD).
Kate Johnson explains in The NYT that the sedatives doctors use for “twilight” awareness during surgery also have the side effect of amnesia, which is why you’re usually told, “You’ll be awake, but you won’t remember.” Unfortunately for Johnson, this effect was lost on her and she continues to relive her trauma.
Johnson has awoken three times while under conscious sedation, twice without negative side effects, but once that left her haunted by flashbacks and nightmares. It’s a very small percentage who recall unsettling experiences under conscious sedation – three out of every 10,000 people. In general anesthesia, the number is two out of every 10,000, according to a neuroanesthesiologist from the University of Michigan who also found the following: When a patient does wake under any type of anesthesia, 78 percent felt distress and 40 percent had long-term psychological effects.
Do You Have an Anesthesia Error Lawsuit?
Research about anesthesia awareness in conscious sedation is small, which makes forming a hypothesis and finding solutions an ongoing challenge. The majority of people have no memories of being under any form of sedation. Those who do remember can suffer for life.
If you have suffered a preventable anesthesia error, schedule a consultation with the Michigan medical malpractice lawyers at Thurswell Law to discuss whether you have a case. We do not charge any fees unless you collect. Call (248) 354-2222 today.
