Can you imagine what it is like to have an operation, but for the anaesthetic to have failed? You can see and hear everything around you, you may even be able to feel the pain from the surgeon’s knife, but the drugs have left you paralysed. Patients who have had this happen to them often describe the feeling of screaming at the top of their voices, but are unable to move or to be heard.
The incidents of anaesthetic awareness are mercifully rare, and are estimated to be in the region of 1 to 3 patients in every 1000 (although this is said to jump to around 1 in 100 for higher risk operations such as cardiac surgery, major trauma operations and emergency caesarean sections). In considering that 3.5 million general anaesthetics that are administered in Britain every day, this would suggest that there is the potential for 4000 cases each year.
For the unfortunate minority who do wake up, either before or during their operations, the impact on their lives can be devastating. Patients can suffer from extreme post-traumatic stress disorder, having regular, vivid flashbacks back to the operating table, nightmares of the operation itself, then more creative dream sequences involving traumatic situations of helplessness
Vivid recollections of the operation however are only part of the story, nightmares can set in, and often a persistent anxiety. Many develop phobias of the hospital where the operation took place, to the point where they can’t even drive past it, and many start avoiding their GPs and/or dentists. Added to that are the knock-ons that can cause as much damage again. Depression sets in, jobs are left and lost, relationships dissolve.
What staggers many researchers in the field, however, is not the number of cases, but the failure of many medical staff to use any of the techniques developed to reduce anaesthetic awareness further. Brain monitors can show just how sedated a patient is, and even a simple tourniquet can make the difference between a patient feeling helpless and being able to move enough to alert the surgeon.
The disbelief that the patient’s often come across when they try to recount their stories, is sometimes more difficult for them to deal with than the actual experience itself. They can be left feeling mistaken or at worse silly, complaining and problematic.
When I have seen clients who have suffered in this way, it is important to listen to them carefully and to identify what they need in terms of resolution of their complaint and to help them to deal with this traumatic event.
As well as obtaining compensation (£15,000 for a lady who was “awake” during an ocular implant operation), I shall seek to obtain an apology from the hospital Trust – as an apology can be considered to be an acknowledgement of what happened, and of what my client has experienced.
Added to this is the fact that the damages are often used to secure counselling for the client in a real attempt to help them to deal with what has happened and to move on.
Finally, it is interesting to note that currently it is considered that red headed patients and women are more likely to suffer with anaesthetic awareness than others. This is due to a number of (speculative) reasons, but I certainly think that in recognising this, it might be the first step (by the hospital clinicians) in realising that this is happening and that greater care needs to be taken with the administration and monitoring of anaesthetics.