When Patients Wake Up During Surgery!

Experts disagree on how best to prevent the problem

Facing surgery to remove her right eye, Carol Weihrer was taking it in stride.

"I went into this with a very good frame of mind," Weihrer, now 53, of Reston, Va., said of the operation performed more than eight years ago.

She'd been struggling with a serious condition called corneal erosion syndrome, and could no longer stand the pain. So Weihrer decided the surgery was the best solution.

Little did she know the nightmarish experience would alter her life. And it began on the operating table.

"I remember hearing disco music, and then I heard the surgeon say to the resident, 'Cut deeper,'" Weihrer said. "I realized I was awake and the surgery had just started."

She tried frantically - and futilely - to blink her eyes to alert the surgeons. She couldn't move her head, either. "I was screaming at the top of my lungs but no noise was coming out."

Weihrer experienced "anesthesia awareness" - or what doctors call "awareness with recall" - when patients aren't fully anesthetized and are aware they're being operated on.

Earlier this month, the Joint Commission on Accreditation of Heathcare Organizations, which accredits 16,000 U.S. hospitals and other health-care facilities, issued an alert about anesthesia awareness. It called the phenomenon an "under-recognized and under-treated" problem.

The commission suggested that hospitals and health-care facilities that perform surgery using general anesthesia develop a policy that includes, among other steps, education of staff, identification of patients at particularly high risk and conducting postoperative follow-up to detect any problems. The group also recommended that hospitals ensure that patients who suffer mental distress after enduring anesthesia awareness be given access to counseling or other support programs.

While the exact number of patients affected by anesthesia awareness isn't known, a study published earlier this year in Anesthesia and Analgesia estimated the number at one to two patients per 1,000. That translates to 20,000 to 40,000 patients annually in the United States, according to the commission.

For some, the experience is so terrifying they suffer post-traumatic stress syndrome (PTSD), said Dr. Peter S. Sebel, a professor of anesthesia at Emory University School of Medicine in Atlanta, who co-authored the study in the anesthesia journal.

Weihrer said she has suffered PTSD since her ordeal.

"I have all the classic symptoms. I have not slept in a bed for six-and-a-half years, I can't lie down in a bed," said Weihrer, who sleeps in a chair. She also sees a psychiatrist every one to three weeks, she added.