When my daughter was 5 years old, she had a T&A. From the time of her surgery to now (8 years later) she insists she woke up during the procedure. I always tried to pass it off as nothing. I would tell her it was probably the very beginning of the surgery when they would roll you in the OR and then start sedation.
Now that she is older she adamantly insists that she was asleep and when she woke up she seen them in their garb and scalpels in hand, They told her it was okay and to go back to sleep.
They never told me after the surgery she woke up. I never asked, really thinking my daughter was confused. It doesn't appear she suffered any mental anguish or anything. She just states it as fact. I believe her now, because she has been so consistent with her story for such a long time.
However, if she did wake up, shouldn't they had said something? I know that getting the right med combination can be tricky, I have done conscience sedation in pediatrics alot in the ER. However, for any future surgery this would be good to know and report off, so that it can be handled better in a more invasive case.
Yes she did wake up at some point, saw the surgeon, they said it is okay go back to sleep, she did go back to sleep.
Should they have mentioned it to you? Of all the horrible things that can and do happen with T&A's I think a minor "I woke up...went back to sleep" incident would, I hope, be readily forgotten by the OR staff so they could focus on....is she bleeding, is her heart rate and oxygen level good, are we maintaining fire safety, is everything sterile, etc.
Are you concerned that in future surgeries she might need more or different sedation because she woke up during the T&A? If you want you could request her medical record and find out what they used?
Anesthesia and sedation has changed over the past 8 years and continues to change. I can't see any reason to give it a second thought?
Specializes in Oncology; medical specialty website.
I'm going to have an endoscopy in a few weeks. I told the gi that I was really anxious about it because the last one was terrible. I felt everything. I was gagging so hard tears were streaming from my eyes. The doc started yelling at me to stop gagging. ("If you don't stop gagging I'm not going to be able to finish this procedure!"--direct quote) She reassured me that this time I would be properly sedated.
I know it sounds minor, just an endo, but I still remember that terrifying feeling of choking and being screamed at. It was almost ten years ago, and it still shakes me up
To a kid, anything a surgeon's hand could be "scalpel", I think you're hugely overestimating a 5-year-old's knowledge of surgical equipment.
I'm not the one that used the word scalpel, the OP did and I'm not overestimating (or underestimating) anything just responding to the description provided by the OP. Having raised two kids of my own, and being in the process of helping to raise 4 grandkids, it would not be an estimation of any kind to state that even children this age know the difference between a pen and a knife. If this child had said they saw a pen in the surgeon's hand, I would categorically state that I believe this child did wake up at some point. By the time an average child reaches 5 years they have a vocabulary of anywhere between 2,000 and 2,200 words. This is adequate to describe the difference between a knife and a pen (which is what an ESU cautery device looks like) Rather than overestimating the intelligence and vocabulary of this child, I would respectfully suggest that you are underestimating them. A five year old pretty much knows that they have seen and experienced and this description simply doesn't fit.
I woke up as I was being stitched up during my emergency c section, I was intubated and remember gagging frantically and trying to bend forward to sit up. Luckily I don't remember any pain, they never mentioned this to me and I just never thought to bring it up, I wonder what they would have said if I did?
They did mention as soon as they extubated me I was screaming because I thought the baby died, I don't remember this though, thankfully.
Unfortunately trauma, OB, and heart surgery run the greatest risk of recall do to the emergent nature of the surgeries and the limitations on types of anesthetics that can be used.
Specializes in Peds ED, Peds Stem Cell Transplant, Peds.
Yes, my daughter mentioned scapel. However, since we didn't have TV at that time, I doubt she even knew what a scapel was. If it was a cautery that could have been what she thought was a scapel. as for being intubated, I doubt she was. I don't do OR, so I don't know, do they normally intubated with an OPA with a T&A? I am thinking of the mechanics can they even get to the Tonsils with an ETT in place? I don't know just asking.
I'm not the one that used the word scalpel, the OP did and I'm not overestimating (or underestimating) anything just responding to the description provided by the OP. Having raised two kids of my own, and being in the process of helping to raise 4 grandkids, it would not be an estimation of any kind to state that even children this age know the difference between a pen and a knife. If this child had said they saw a pen in the surgeon's hand, I would categorically state that I believe this child did wake up at some point. By the time an average child reaches 5 years they have a vocabulary of anywhere between 2,000 and 2,200 words. This is adequate to describe the difference between a knife and a pen (which is what an ESU cautery device looks like) Rather than overestimating the intelligence and vocabulary of this child, I would respectfully suggest that you are underestimating them. A five year old pretty much knows that they have seen and experienced and this description simply doesn't fit.
Specializes in OR, Nursing Professional Development.
All of our T&As are done with ETT. It's a reinforced tube so that it can hold up to the cautery. The ETT is also because of working in the throat- that can cause airway issues; having an ETT is simply the best way to protect the airway and ensure a definitive airway.
When my daughter was 5 years old, she had a T&A. From the time of her surgery to now (8 years later) she insists she woke up during the procedure. I always tried to pass it off as nothing. I would tell her it was probably the very beginning of the surgery when they would roll you in the OR and then start sedation.
Now that she is older she adamantly insists that she was asleep and when she woke up she seen them in their garb and scalpels in hand, They told her it was okay and to go back to sleep.
They never told me after the surgery she woke up. I never asked, really thinking my daughter was confused. It doesn't appear she suffered any mental anguish or anything. She just states it as fact. I believe her now, because she has been so consistent with her story for such a long time.
However, if she did wake up, shouldn't they had said something? I know that getting the right med combination can be tricky, I have done conscience sedation in pediatrics alot in the ER. However, for any future surgery this would be good to know and report off, so that it can be handled better in a more invasive case.
We tape their eyes routinely and she i say routinely I mean every time. She may have had a bad dream mixed with anxiety from the procedure. Did she have ketamine? It can cause hallucinations. Did she have versed with the ketamine? If not then this could be the cause. If she had oral versed right before going back it would not have time to counteract the ketamine side affects.
We also perform these procedures with LMAs and not always with an ETT. These are quick procedures an I try to get them breathing again on their own ASAP.
My mother died with anxiety over how my sister, 23+ years ago, woke up during an exploratory surgery before she was scheduled to have open heart.
I even remember my sister talking about it happening for several years. Until she was about four or five. And then she stopped talking about it. You ask her now and she can't remember it. My mom carried that memory to her grave. Unnecessarily, in my opinion.
Unfortunately trauma, OB, and heart surgery run the greatest risk of recall do to the emergent nature of the surgeries and the limitations on types of anesthetics that can be used.
Absolutely, they were extremely rushed. Thinking about this happening during heart or trauma surgery makes me cringe!
My mother died with anxiety over how my sister, 23+ years ago, woke up during an exploratory surgery before she was scheduled to have open heart.
I even remember my sister talking about it happening for several years. Until she was about four or five. And then she stopped talking about it. You ask her now and she can't remember it. My mom carried that memory to her grave. Unnecessarily, in my opinion.
brownbook
3,413 Posts
Yes she did wake up at some point, saw the surgeon, they said it is okay go back to sleep, she did go back to sleep.
Should they have mentioned it to you? Of all the horrible things that can and do happen with T&A's I think a minor "I woke up...went back to sleep" incident would, I hope, be readily forgotten by the OR staff so they could focus on....is she bleeding, is her heart rate and oxygen level good, are we maintaining fire safety, is everything sterile, etc.
Are you concerned that in future surgeries she might need more or different sedation because she woke up during the T&A? If you want you could request her medical record and find out what they used?
Anesthesia and sedation has changed over the past 8 years and continues to change. I can't see any reason to give it a second thought?