I woke up during surgery, Have you? - page 8
I was responding to another thread the other day and made mention of the fact that I woke up DURING my last surgery. I got to wondering if this had ever happened to anybody else, so I thought I'd... Read More
Dec 28, '06Occupation: RN Joined: Nov '03; Posts: 4,389; Likes: 153Quote from RNLouThanks for a very informative post Lou. I just had general anesthesia for surgery and I did not wake up at all.Again, let me stress, sedation is not general anesthesia. If you awoke from your sedation, you did not suffer from awareness under general anesthesia. You may have heard conversations in the room, you may recall sounds & lights. You did not suffer awareness under anesthesia.
I was totally out for the whole thing.
I kind of wish they had told me when they were putting me out though ... kinda freaky when you wake up like ... what just happened?
As for the Versed ... made me feel like I was drunk. All I remember was rambling on about meds or something ... then I was out.
Side effects were worse than I thought they would be ... hellava hangover. Took me a day to be able to eat anything.
:typingLast edit by Sheri257 on Dec 28, '06
Dec 28, '06Joined: Dec '06; Posts: 50; Likes: 4I have been very fortunate to never wake up during surgery. After a recent orthopedic procedure four months ago, upon waking up, didn't even need supplemental oxygen after extubation. Fortunately, because I have never smoked, don't drink, etc. and I'm in excellent cardiovascular health, my body perfuses well. Though, I do remember when coming to in recovery, expressing my thoughts on how adorable my surgeon is. He was surprised I remembered our conversation when he checked on me the next day.
Dec 28, '06Joined: Nov '05; Posts: 346; Likes: 18[quote=KellieNurse06;1950656]OMG!!! I hear ya! I actually had a nursing instructor last year mention something like this to us......she said people will always say stuff about hoping the surgeon is good , knows what their doing etc....and well ...what about the person putting you under.. ..........funny
my mom always interviews and checks out the anethesiologist and insists no one also.
Dec 28, '06Occupation: RN Specialty: 2 year(s) of experience in critical care, PACU ; From: US ; Joined: Nov '06; Posts: 1,278; Likes: 1,132Quote from cozmo_blozmoThis is true. My boyfriends father was getting more stents put into an artery and then the surgeon nicked another artery. He specifically remembers hearing the md say "oh ****" and was awake while they tried to repair things.People need to understand that not all surgeries require patients to be asleep. Many surgeries are done while the patients are completely awake. People have a misconception that they are unintentionally awake when they have a spinal or a regional anesthesia the fact is you are suppose to be. The main point is you should not be in a lot of pain. As far as recall emergency C-sections and Cardiac surgeries have the highest recall rates.
Dec 29, '06Occupation: going to school to become a Medical assistant then im going to go on to get my RN Joined: Nov '05; Posts: 453; Likes: 10I never had that happen to me but im sorry to hear that about your surgery
Dec 29, '06Occupation: Tech in the ED at a level I trauma center for 2 years! Now working as an RN in the CCU! Specialty: ER, CCU ; Joined: Apr '05; Posts: 108; Likes: 9i don't know if anyone has mentioned this book yet (i didn't have time to read all the posts)
But i went to a NSNA convention my freshman year in college, 4 years ago and there was a speaker who talked about this particular problem. I've also watched the show on the discovery health channel about it.
There is an excellent book called Silenced Screams by Jeanette M. Liska. It's a first hand account of awareness during surgery. She however never went to sleep, the only meds that worked were the ones that paralyze you. She felt and heard everything. It's a highly interesting book, and i recommend it. I could not find it anywhere at the local bookstores, i ended up getting it off of !!
Dec 29, '06Occupation: home health Specialty: med/surg, geri, ortho, telemetry, psych ; Joined: Oct '06; Posts: 693; Likes: 30I will never forget when I was in LPN school, many years ago, that they told us that the job of the anesthetist is to get the patient as close to death as possible, without actually killing them. Scary.
Dec 29, '06Occupation: veterinary technician or veterinary nurse (depending on what counry you're in) Joined: Jan '04; Posts: 929; Likes: 586Quote from jill48Yup, veterinary technicians do the same thing with people's animals. Which is why I'm always floored whenever I hear of a veterinary hospital using non credentialed people to induce, monitor and maintain anesthesia. Very scary what goes on "in the back".I will never forget when I was in LPN school, many years ago, that they told us that the job of the anesthetist is to get the patient as close to death as possible, without actually killing them. Scary.
Dec 30, '06Joined: Mar '03; Posts: 161; Likes: 12Quote from subeehow could they record the incident if they didn't know it happened until you were seen post-op? awareness during surgery is very rare, but it does happen. usually, the patient hears noises in the room but does not feel pain. that is because you (usually) have enough narcotics and gas in your system to block pain impulses but have not received enough amnesiac medications. if you read the entire thread, you will discover the type of surgeries and patients most prone to recall. however, you were kept too "light" and should have had both more narcotics and amnesiacs in your system. avoiding amnesia involves more art than merely providing pain relief and if you had a resident or new practitioner, you got assigned someone at the bottom of the learning curve. you may have given no visible signs of being aware (we don't have reliable monitors for awareness) and there's no reason for your surgeon to suspect that you experienced awareness unless you told him or her. it must be traumatic for you - sorry someone failed you.
my post that you quoted, along with the above reply, was the original post that i made when i started this thread. i found your post a little confusing, until i realized that you must not have seen the additional posts that i made to this thread that explained in a little bit more detail about my experience.
just to reiterate, i had my surgery done at a reputable teaching hospital by a world renowned surgeon. i only recalled seeing the overhead surgery lights, hearing a banging noise, and feeling excrutiating pain. it was the anestheseologists (sr crna and a resident) themselves who came to my room and informed me that i was trying to pull on things and trying to get up off of the table during my surgery, which i did not recall. they explained that the banging i heard was the surgeon pounding the acetabulum hardware into place during my hip replacement.
so, there were definately visible signs that i was awake during the surgery. the anesthesiologists, surgeon, and anybody else in the room, couldn't have missed it and knew long before my follow up appt. so, there is no excuse what-so-ever as to why this incident wasn't noted anywhere in my records. especially considering that both the anesthetists came and talked to me about it. unless they thought i was so out of it on dilaudid at that time, i may not remember our conversation. (my father was visiting when one of them came to see me) who knows....i just thought it odd that it wasn't noted anywhere.
i have read this entire thread and have found some very informative information from other posters. as traumatic as it was for me, i'm just greatful that i didn't experience the paralyzes and inability to let anybody know i was aware, like others who posted have experienced. i can only imagine how horrific that must have been. thanks again for your replies everyone.
go gators!! sec champions!!
national championship bowl bound
Jan 2, '07Occupation: Infection Control/Employee Health Nurse Joined: Mar '06; Posts: 12; Likes: 2Gator RN, I was inpatient for a abscess (thanks to staff & Docs poor sterile technique and short cuts) that developed after abdominal surgery. I began to have chest pain, SOB, nausea during an MRI. I begged the tech to stop and his response was he was almost done... The time was 2230. The tech gave me O2-took my pressure and I was taken back to my room. I hit the call light and told the nurse I was having chest pain. She acted all disgusted-burnout-you know the end of a 12hr shift. I waited...at 2330 I hit the light again-night shift nurse came in and I asked if the other nurse reported my chest pain-No, she did not. Night nurse said she would call the Doc. Now it's 0100-intern came in and tried telling me it was GERD!!! Still no EKG yet. The night nurse called in a different Doc (thank the Lord). He said where's the stat EKG that was ordered? The EKG revealed A-Fib. He gave me cardiazem which converted me quickly and I went to CCU. My hospital file stated tachycardia from fever and nothing else...
Nov 26, '07Specialty: OB, HH, ADMIN, IC, ED, QI ; From: US ; Joined: Jun '06; Posts: 2,340; Likes: 2,045In 1974, it was the practise to put patients under "light" anaesthesia while removing a breast lump, do a "frozen" section, and then proceed with a "modified radical mastectomy" if the cells indicated that was necessary.
My doctor, a general surgeon, had been a student in my prenatal classes, and the only doc I could raise on Columbus Day, after discovering my 0.5cm lump during Breast Self Examination (which I ardently did and taught, as an American Cancer Society volunteer due to my mother having had breast cancer 32 years before dying of ovarian cancer).
During the lumpectomy, I heard my doctor say, "oh, my God, it is!" But I had no pain. He'd been very calming (I was on the ceiling and the walls), saying that at 34 I was much too young to have cancer. Nevertheless, I woke up with the big bandage. He'd asked if I wanted to be awakened from anaesthesia and told the results of the pathologist's examination of the tissue, and given the option of having the big surgery later. I'd said that I'd know by how big the bandage was when I woke up, what the results were, and I'd rather get it all over with, thank-you-very-much.
Nevertheless, it was a surprise, because I'd had the snobbish attitude that I'd have cancer only in a big, teaching hospital - and this was a small one in the suberbs......
Later I asked him if he'd said "Oh my God it is!" at surgery, and he was appalled that I'd heard that. He affirmed that he'd said it.
Nov 28, '07Occupation: Registered Nurse From: US ; Joined: Jun '07; Posts: 432; Likes: 316Quote from mistersisterThat is fascinating. Thanks!Hello all.
This is my first post on allnurses though been reading for awhile. I've been an anaesthetic nurse (now in ICU for awhile) for several years (in Oz it's not the same as a CRNA, but we're like the scrub nurse is to the surgeon - and then some).
The incidence of awareness under anaesthetic is actually fairly high (something like 1 in 25000) but mostly (and admittedly not exclusively) limited to three types of surgery - trauma (loss of blood due to massive haemorrhage takes the drugs into third space loss and disrupts first pass metabolism, in addition to all the other metabolic disturbances), general anaesthetic cesaerean sections (gotta keep the doses light so you don't anaesthetise the baby as most drugs cross the placenta - usually ok from breast milk if surgery post delivery as long as first feed is expressed
post GA) and cardiac surgery (due to most of the surgery being run on something like a high dose larazepam (long acting benzodiazepine like a souped up midazolam) premed and fentanyl (synthetic opioid narcotic 1000 times stronger than morphine - not sure what its called in the US). Cardiac surgery is done this way because the other maintenance drugs we use (both inhalational and IV) are useless in the face of the cardioperfusion bypass machine - sort of ventilator/heart pump/metabolic dialysis machine.
Now the good news - the chances of have awareness in any other surgery is, nowadays, pretty low. We've got a new monitor that measures the pt's level of consciousness - something we just couldn't do until recently. We could infer by other parameters, but as has been pointed out - we're giving you drugs to cease (or sometimes just lower) respiration, lower heart rate and BP, so how much of that is actually lowering you're consciousness? There's the problem. We also based doses for inhalational agents on MAC, (mean alvoeolar concentration) which essentially is the concentration of the agent at the alveolus (also inferred) and based on the idea that 50% of patients had no reaction to surgical stimuli (in studies) therfore, at this dose the pt is probably asleep.
Strangely, one of the main drivers for the use of this monitor is to reduce the cost of drugs administered to pt's under anaesthesia. It was found that a goodly percentage of practitioners actually gave higher doses than they needed to - this increased drug costs, PACU time and ultimately length of stay.
'Course, any reason to institute widespread practice of this monitor is a good one, given its obvious benefits at reducing the incidence of this traumatic experience. The tip is it'll probably be compulsary in a few years, a bit like those pulse oximeters everyone said couldn't be trusted or wouldn't last.
Won't take up much more time because it's a big subject, and this is only an insight into some of the issues involved - how does it happen, should we admit it (yes we should), when is it negligence, etc.
Thanks for reading.
Nov 28, '07Occupation: Nursing Faculty Specialty: 15 year(s) of experience in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research ; From: US ; Joined: May '02; Posts: 8,317; Likes: 6,285The monitor mentioned in mistersister's post is called a Bis Monitor. It reads an EEG while you're under anasthesia, and can tell how 'deep' the patient is. We also started using them in the ICU for our sedated patients. I love them!