Sleepless at surgery

According to the American Society of Anesthesiologists (ASA),incidences of awareness occur once or twice every 1000 surgeries performed under general anesthesia. “Regardless of statistics,even one case of anesthesia awareness is too many,” says Dr. Anil Santh ,head of department of Ruby Hall,Pune. “The entire team responsible for the patient in the operating room should be extremely vigilant before,during and after surgery to ensure the safety,comfort and safe recovery of each and every patient. Intra-operative awareness remains an undesirable complication with a serious potential for the development of post-traumatic stress disorder (PTSD). Assessing the depth of anesthesia remains a challenge for the anesthesia provider as clinical signs may often be unreliable and also because there are no specific clinical signs of awareness. Following surgery,patients who believe they may have experienced anesthesia awareness are encouraged to contact their anesthesiologist regarding their experience. The first step in overcoming the adverse emotional consequences of an intra-operative awareness experience is the acknowledgment of it having occurred.

“Intra-operative awareness is obviously a terrible complication,and clearly we need to do everything we can to prevent it,” says Santh. The medical community is aggressively addressing intra-operative awareness,but there are things that even the patients should do to limit their risk . First of all,listing down all medications before surgery as some might make your body metabolize things more quickly. One also needs to give a brief account of family history and medical risk factors and especially the addiction habits if any.

Now,monitors like BIS (biospectral index stimulator) and entropy monitor are available to assess the depth of anesthesia. Incidence of awareness can be made six sigma compliant through effective training of anesthethesiologists,availability of new monitors,awareness amongst doctors,public,hospital managers and adequate legislation. Prior to surgery,the anesthesiologist should evaluate the patient’s medical condition and formulate an anesthetic plan,taking that patient’s physical condition into account. It is vital that the anaesthesiologist knows as much about your medical history,lifestyle,and medications as possible.

Once the surgery is scheduled,one should not forget to find out who will be your anesthesiologist. It is wise to find out about their credentials,training,and safety record. It could be the most important research you do to protect your safety when undergoing any surgical procedure.