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Waking Up During Surgery (2019)

mosaicscience.com

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Re: Waking Up During Surgery (2019)

#101

Post by fifteenforty »

lr4444lr wrote: post #28

Just an anecdote: I once had a procedure that required I be under a "light" general anesthesia (don't recall which). I was generally paranoid at the time though about everything, and strapped an audio recorder to my leg secretly. Turns out I did wake up mid procedure (the audio suggests doctor and nurse rushed to stop me from touching the area of operation of my face, and that I was distressed) but as the doctor prom…

There is no such thing as ‘light’ general anaesthesia. It’s a terrible term used only by non-anaesthetists. Did you have sedation? Movement with sedation is extremely common and not a concern. With sedation, we aim to provide comfort and relief from the anxiety-inducing parts of the experience, not unresponsiveness to noxious stimuli and lack of recall.

Re: Waking Up During Surgery (2019)

#102

Post by fifteenforty »

lr4444lr wrote: post #28

Just an anecdote: I once had a procedure that required I be under a "light" general anesthesia (don't recall which). I was generally paranoid at the time though about everything, and strapped an audio recorder to my leg secretly. Turns out I did wake up mid procedure (the audio suggests doctor and nurse rushed to stop me from touching the area of operation of my face, and that I was distressed) but as the doctor prom…

Please don’t bring a recorder. It puts you at risk because when we ask if you have any devices, we expect an honest answer. If it is discovered you will lose the trust of your treating team. You can get electrical burns if certain equipment is used. You could have recorded conversations about other patients, which you are not entitled to do.

Re: Waking Up During Surgery (2019)

#103

Post by fifteenforty »

azalemeth wrote: post #13
flave wrote: post #2

Okay this is an interesting article and an interesting subject. But, it looks a lot like fear-mongering. I feel strongly about this because I had two procedures done under local for fear of exactly this situation (coming up but being sedated) and both experiences where tough . > Founded in 2007, it has now collected more than 340 reports So 24 self-reported cases a year in all of N America. There are 48 million in pa…

I've had three general anaesthetics, all as a child or teenager. I only remember "the anaesthetic" for one of them: a large dose of what I now know to be propofol went in a cannula and the (attractive, for a 14-year-old) nurse stroked the cannula on the back of my hand after it was administered. That felt warm and nice. Purple butterflies them started to come up out of my hand, through the back of the venflon, and ca…

Unfortunately, awareness during ‘competent’ general anaesthesia is not entirely avoidable. First, if we were to give all patients a dose of hypnotic agent that would absolutely prevent awareness, a not-insignificant number would die or be disabled from the acute cardiovascular effects. So, we don’t. We give doses that make the risk very small, but not zero. It’s a balance of risks.

Re: Waking Up During Surgery (2019)

#104

Post by Doxin »

wittyreference wrote: post #21
flave wrote: post #2

Okay this is an interesting article and an interesting subject. But, it looks a lot like fear-mongering. I feel strongly about this because I had two procedures done under local for fear of exactly this situation (coming up but being sedated) and both experiences where tough . > Founded in 2007, it has now collected more than 340 reports So 24 self-reported cases a year in all of N America. There are 48 million in pa…

They went on to describe the forearm experiment which showed a much higher rate of awareness. I don’t see why you’ve chosen to omit that. You seem to casually discard the idea that awareness without memory is irrelevant, but when I’ve informed patients of amnestics they’ve been horrified - maybe needlessly so, but I’m not so arrogant as to think “silly patient, your horror is wrong and therefore irrelevant.” Many peo…

> Many people don’t regard “you’ll be in pain and then forget” as the same as “no pain.”

This makes perfect sense to me. Forgetting the pain is nice for future-me, but doesn't do anything for current-me. There will be a period where I am in pain and am aware of it. Forgetting it later is good for your mental health presumably, but forgetting something doesn't erase it from existence.

Re: Waking Up During Surgery (2019)

#105

Post by lr4444lr »

Der_Einzige wrote: post #73
lr4444lr wrote: post #28

Just an anecdote: I once had a procedure that required I be under a "light" general anesthesia (don't recall which). I was generally paranoid at the time though about everything, and strapped an audio recorder to my leg secretly. Turns out I did wake up mid procedure (the audio suggests doctor and nurse rushed to stop me from touching the area of operation of my face, and that I was distressed) but as the doctor prom…

Sorry, but there is nothing else to say except that you are extremely wrong. This kind of belief is exactly why male circumcision is not seen for the evil that it is. Please try to consider the possibility that trauma without conscious memory can have disastrous results - as other commenters are trying to get you to understand...

Circumcision (as commonly practiced) is generally seen as "evil" because infants lack the power of consent to refuse. I'll gladly consider pain without memory to be "disastrous" if you can marshall enough evidence for that.

Re: Waking Up During Surgery (2019)

#106

Post by lr4444lr »

fifteenforty wrote: post #102
lr4444lr wrote: post #28

Just an anecdote: I once had a procedure that required I be under a "light" general anesthesia (don't recall which). I was generally paranoid at the time though about everything, and strapped an audio recorder to my leg secretly. Turns out I did wake up mid procedure (the audio suggests doctor and nurse rushed to stop me from touching the area of operation of my face, and that I was distressed) but as the doctor prom…

Please don’t bring a recorder. It puts you at risk because when we ask if you have any devices, we expect an honest answer. If it is discovered you will lose the trust of your treating team. You can get electrical burns if certain equipment is used. You could have recorded conversations about other patients, which you are not entitled to do.

Yeah, not that'd I'd do it today because mental health is better, but it was pretty low risk. The surgery was on my nose, and the recorder was a cheap alkaline battery one (4.5 volts) strapped to my leg below the knee.

Re: Waking Up During Surgery (2019)

#107

Post by nerdponx »

DHPersonal wrote: post #34
lr4444lr wrote: post #28

Just an anecdote: I once had a procedure that required I be under a "light" general anesthesia (don't recall which). I was generally paranoid at the time though about everything, and strapped an audio recorder to my leg secretly. Turns out I did wake up mid procedure (the audio suggests doctor and nurse rushed to stop me from touching the area of operation of my face, and that I was distressed) but as the doctor prom…

I recall hearing about this phenomenon about a decade ago, and at the time someone theorized that the specific memory may be lost but the effects were still present, and that these effects could cause general anxiety and distress without the person understanding the reasoning. I think it is perhaps more philosophical than rational, but it did give me pause to consider that perhaps not everyone forgets enough of a sur…

Apparently upper GI endoscopy procedures are conducted under very very mild sedation, I believe typically using propofol.

The most recent one I got, I had disturbing hazy dreams the next two nights where I was conscious of the scope down my esophagus. I would not be surprised if it was less dream and more of a memory fragment.

Re: Waking Up During Surgery (2019)

#108

Post by nerdponx »

lr4444lr wrote: post #28

Just an anecdote: I once had a procedure that required I be under a "light" general anesthesia (don't recall which). I was generally paranoid at the time though about everything, and strapped an audio recorder to my leg secretly. Turns out I did wake up mid procedure (the audio suggests doctor and nurse rushed to stop me from touching the area of operation of my face, and that I was distressed) but as the doctor prom…

Was it true general (full intubation, paralysis, etc.) or "conscious sedation" (falling asleep with no memory and an oxygen tube next to your nose)?

Waking up and trying to move would make sense under conscious sedation. Seems very unlikely under general, given my (non professional) understanding.

I don't believe "light general" is a thing.

Re: Waking Up During Surgery (2019)

#109

Post by nerdponx »

istorical wrote: post #57
cj wrote: post #6

I'm inclined to chalk this up to false memories. Especially if someone is going in with nervousness or awareness that "waking up without being able to alert the surgeon" is a specific point of anxiety of the patient. But, who knows. https://en.wikipedia.org/wiki/False_memory

It's a known phenomenon not a mythological creature like bigfoot. Dentists for example often have to re-administer anesthesia mid-procedure when a patient wakes up mid-wisdom tooth extraction for example.

This is conscious sedation, not general anesthesia. Different animal.

Re: Waking Up During Surgery (2019)

#110

Post by throwanem »

andrewl wrote: post #52
throwanem wrote: post #51

Earlier quoted context omitted.

Sure, I'm aware, and I don't know of any reports of emotional harm as a result of that. I think it'd probably be the combination of pain, helplessness, surprise, and recollection that'd be what causes the trauma in cases where people regain consciousness unintentionally . In the kind of surgery you describe, at most two of those seem likely ever to be present, and because the awareness is intentional I expect there'd…

I thought you were referring to Tapland's report "I remember the doctors asking me after partial removal of a brain tumour if I remembered them waking me up during the surgery" when you said it "would probably be by far the worst agony you'd ever experienced." Accidental awareness during surgery has always sounded massively traumatic to me. Even thinking about it makes me intensely uncomfortable.

I don't know. I have some fairly complex thoughts here, but I'm coming at it as someone for whom there is evidently something deeply weird going on with their whole perception of this category of sensation - I don't find opioids at all pleasurable, either, and it was only a few months ago that I found out how unusual that is. Not that I'd try to change any of this even if I thought I could, but I suppose it doesn't really equip me to talk on the subject in a way that'd likely be of use to anyone normal.
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