Psychosocial Outcomes of Anesthesia Awareness Evaluated in Study

Although any type of surgical error can have devastating consequences, anesthesia awareness arguably inspires more fear among patients than many other types of medical mistakes.

Anesthesia awareness, although rare, is a serious issue that involves wakefulness while under general anesthesia. The patient is aware of what’s happening during the surgery, and the patient may or may not experience pain or discomfort. It is often thought that wakefulness during surgery has the potential to lead to post-traumatic stress disorder (PTSD), a serious psychological condition that can develop after a highly stressful event. Sufferers of PTSD often report emotional and cognitive symptoms such as depression and memory loss, as well as physical symptoms such as rapid heartbeat.

Now, a new study has explored the potential for PTSD in patients who suffered from anesthesia awareness. The study was published in the July 2014 issue of Anesthesia & Analgesia. The study authors are researchers at the Centre for Military Medicine in Finland.

No evidence of PTSD found

The researchers evaluated data from nine patients who had undergone surgery without reporting anesthesia awareness problems and nine patients who did experience wakefulness during surgery. Those patients were studied for 17 years, during which clinicians conducted psychiatric diagnostic interviews. The nine patients who suffered from anesthesia awareness were able to describe what took place during their particular surgeries with great accuracy. However, the measurements of their quality of life were comparable to that of the control group. The patients did not appear to exhibit adverse psychosocial effects from their experiences over a long-term basis.

“We found no indication that intraoperative awareness with recall had any deleterious long-term effects on patients’ psychosocial outcome,” said the lead study author, Dr. Tanja Laukkala.

The patients were not diagnosed with PTSD, nor did their experiences fulfill the criteria for a “potentially traumatic event” that could result in PTSD.

The researchers were cautiously hopeful about the results of the study. However, they noted that more research was necessary in this area. The study involved a small group of patients, at least in part because those who have suffered from anesthesia awareness problems are few and far between. Unfortunately, there are many more patients who suffer from other types of anesthesia mistakes during surgery.

Types and effects of anesthesia errors

A survey of members of the Canadian Society of Anaesthesiologists found that of the 2,266 respondents, an alarming 30 percent admitted to experiencing a minimum of one error during their career. And a survey of the Japanese Society of Anaesthesiologists found that out of 27,454 anesthesia procedures conducted over an eight-year period, 25 percent involved an overdose, 23 percent involved a substitution error, and 21 percent involved an omission error.

Some of the most common types of anesthesia errors that may later lead to a medical malpractice lawsuit include administering an overdose of an anesthesia drug, delaying the delivery of anesthesia, administering the wrong drug, and failing to prevent interactions between anesthesia drugs and other medications.

Patients who suffer from anesthesia awareness typically receive too little of the drug. Other common errors include failing to properly instruct the patient about pre-operative preparations, and using defective devices and medical equipment during the delivery of anesthesia.

These anesthesia errors can result in side effects ranging from minor (dizziness, blurry vision, and confusion) to significant (brain or organ damage, heart function problems, and birth defects). These errors may be fatal or potentially fatal, causing complications such as stroke, coma, and cardiovascular collapse.