Awareness under anaesthesia

The child’s mother said, “Have you seen that new film about being awake when you’re having an operation?”  “Er, no. (Pause).  Was it any good?”  I asked hopefully.

I was just about to ‘induce’ (put to sleep) her six-year old, who was eyeing me with suspicion.  I had visited the mother and child just before the start of the session and my usual consultation had not elicited any discussion of awareness under anaesthesia (that’s what we anaesthetists call being awake during surgery, when you’re not supposed to be).

Happily, the surgery passed off with nothing untoward and mother and child were soon re-united.

However, the incident highlighted a couple of points:

  1. Patients don’t always voice their concerns at convenient moments
  2. Communication of risk information is difficult, but important
  3. Awareness under anaesthesia is terrifying and real
  4. Always chose a local or regional anaesthetic technique if available
  5. Err on the side of giving a bit more anaesthetic than not enough with paralysed patients.  Why sail close to the wind?

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