This entry was posted by Sunday, 23 January, 2011
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"Is it my imagination or is this one kinda restless?"


Although it’s UNUSUAL to wake up in the middle of an operation, it isn’t that rare, either.

Not to scare you or nothin’, but I’m lookin at a report in Deutsches Ärzteblatt International by Petra Bischoff and Ingrid Rundshagen. The report states that as many as one in 500 patients experience “unintended awareness” in the middle of an operation. For Massachusetts General, which does about 34,000 surgical procedures a year, that could be 78 people.

Worse for kids. Could be as much as one in 50.

Pop quiz. How many lawyers are there in the United States and what do they do for a living? (Answer: more lawyers than surgeons. More than all the doctors in the country put together. As for what they do for a living, care to guess how some of them are spending their time?)

Anesthesia isn’t just one thing. It consist of

unconsciousness (being asleep)
analgesia (doesn’t hurt)
amnesia (not being able to remember anything bad)
and temporary paralysis (can’t move)
reversibility’s good, too

All this stuff’s supposed to happen simulaneously. In fact, it’s really important that it does.

What happens when things go wrong? One possibility is that you might not be asleep when you’re sposed to be; you might feel what’s going on; you might be unable to move and,  therefore, be unable to let anyone know AND you might remember every horrible moment, later. That’s a really bad combo.

Another possibility: you might experience the pain but not recall the infinitely crappy experience. Does suffering count if you can’t remember it?

So many issues. So few trained philosophers.

Bischoff and and Rundshagen provide some suggestions to anesthesiologists and surgeons about possible steps to avoid unintended consciousness among their patients and MISTER ScienceAintSoBad fervently hopes their suggestions are heeded and lead to more tranquil surgical experiences but, all in all, MISTER ScienceAintSoBad would be a lot happier if he had never reviewed this darn paper.

Some things you just don’t want to know.


I don’t want to scare the pants off of you.

Anesthesiologists sometimes describe patients as being “light”. Doesn’t mean they’re fully awake. There’s an entire spectrum of wakefulness. Bischoff/Rundshagen describe “awareness” but don’t appear to distinguish how awake the patients are. It may well be that many of them are a little more aware than they should be but well south of  being tortured. It’s good to understand some of the things that  can happen during surgery, No need to walk around with a ripe appendix though.


Credits for the above image (which show an operation on a US Navy ship) Creative Commons License
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