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Nov 30, 2007 4:14 pm US/Central
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Doctors Tracking 'Anesthesia Awareness'
'Extraordinarily Rare' Condition Leaves Patients Aware During Surgery
(CBS)
A major film opening this weekend is based on a rare, but scary medical event.
Medical Editor Mary Ann Childers says it's a condition called anesthesia awareness, which is exactly what it sounds like: finding yourself awake and aware while you're having surgery.
It's the basis for a psychological thriller in the R-rated film "Awake."
In the movie, Hayden Christensen plays a patient who experiences anesthesia awareness during a heart transplant. He's awake, but paralyzed.
There is fact behind this Hollywood fiction. The American Society of Anesthesiologists says patients can regain consciousness and remember things.
Some studies estimate it happens in one or two of every 1,000 patients. Most reports of recollections fleeting, but there are rare reports of patients hearing things, not being able to breathe, or feeling pain.
Jeffrey Apfelbaum, M.D., with the American Society of Anesthesiologists, says the condition is "extraordinarily rare. We can't even begin to look at the numbers, but it can happen. Even one case is too many."
Dr. Apfelbaum says the risk is higher for unstable patients such as surgery for gunshot wounds, heart surgery, or an emergency Caesarean section. For those patients, too much anesthesia could be dangerous.
"In some circumstances we understand we're not giving enough anesthesia, but we do so because it's a life and death situation with the patient," Dr. Apfelbaum said.
During surgery anesthesiologists monitor the heart, kidneys, lungs, blood pressure and more. Many hospitals also use brain function monitors to determine the depth of anesthesia. But doctors say the technology is not perfect, not proven, and it's difficult to recognize if and when awareness occurs.
"What we're trying to do is to try to understand how that can occur, and try to completely eliminate it," Dr. Apfelbaum said.
The ASA started a national registry in March to do just that. It's also really important to talk to your doctor before surgery because you can provide information about your health, habits, and history that can help the anesthesiologist help you.
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