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More than 30 years ago, my father underwent an inguinal hernia repair. Upon waking after the surgery, he complained of back pain and graphically described how his back had been twisted while he was undergoing surgery. The surgeon and anesthesiologist firmly denied my father's complaint and told him that his back discomfort was related to a hard OR bed. My father insisted he had been awake during surgery and repeatedly talked about his back being twisted. Despite my father's distress and agitation, health care workers ignored his complaints. He never had surgery again because he feared a repeat of what, for him, was a very upsetting experience.
SCOPE OF THE PROBLEM
Today, a label exists for my father's experience-anesthesia awareness. In fact, research indicates that anesthesia awareness occurs in 0.1% to 0.2% of all patients undergoing general anesthesia.1 This represents approximately 20,000 to 40,000 of the 20 million patients who receive general anesthesia each year.1,2 These patients have described auditory awareness, sensations of not being able to breathe, and pain. Reports of awareness during anesthesia have led to a recent Sentinel Event Alert from the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO). The alert describes the prevention and management of anesthesia awareness and how to support patients who experience it.1 Anesthesia awareness also is known as unintended intraoperative awareness. A patient experiencing anesthesia awareness may be aware of some or all events that occur during surgery. The patient cannot communicate his or her needs or discomfort, however, because he or she has been given neuromuscular blocking agents. Patients who experience anesthesia awareness may develop posttraumatic stress disorder and avoid subsequent surgical care.1,3,4
PERSONAL ACCOUNTS
Numerous reports have emerged about patients who have experienced anesthesia awareness. These include the story of Sidney L. Williams, who experienced anesthesia awareness during open heart surgery.5 Another...