Intra-Operative Awareness (IOA)
More common than thought
Jenny Thompson, Health Sciences Institute, 10/27/2003
A patient identified as "J.L." was undergoing a coronary bypass operation at an Illinois hospital in 1998 when his anesthesia-induced sleep gradually lifted a full 45 minutes before the end of his surgery. Because of a neuromuscular blocking agent that had also been administered, J.L. was temporarily paralyzed and could not communicate with doctors or nurses to let them know he was completely awake and aware. And worse than that, he could feel the pain.
I had heard about the phenomenon of intra-operative awareness (IOA; also known as anesthesia awareness), but until I saw a report on the Today show last week, I didn't realize just how common it is.
Fortunately, this terrifying ordeal can often be avoided when patients are informed about anesthesia dangers and then make a point of communicating their concerns to doctors and anesthesiologists.
many is way too many?
A woman named Carol Weihrer believes the figure is much higher, perhaps higher than 200,000 patients each year. In her opinion, the community of anesthesiologists is reluctant to fully recognize and discuss IOA, and therefore underestimates its effects as well as its frequency. Ms. Weihrer experienced anesthesia awareness during a surgery several years ago. Since then she's made it her mission to educate both patients and practitioners about the risk of IOA.
According to her anesthesia awareness web site, many doctors are unfamiliar with the long-range problems associated with IOA. In the case of J.L., for instance, after his coronary bypass he experienced post-traumatic stress disorder (PTSD), emotional problems, and sexual dysfunction. Ms. Weihrer has also experienced PTSD, including nightmares and flashbacks. And she adds, "The memory never goes away."
gets in the way
In the e-Alert "C Saw" (5/28/03), HSI Panelist Allan Spreen, M.D., explained that a high level of vitamin C is so detoxifying that it can complicate the anesthesia process. He said, "Many times I've had patients tell me that their anesthesiologist was surprised at how much medication was required to knock them out." For those patients who take large doses of vitamin C (something that Dr. Spreen generally recommends), he suggests that they gradually taper off their daily dose until reaching nearly zero just before the surgery.
Finally, never take anesthesia for granted. It's not routine, it's a critical aspect of your surgery. And as the experiences of J.L. and Carol Weihrer have demonstrated, unsuccessful anesthesia can make recovery much longer and more painful than it has to be.
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