But hey, it’s ok if they don’t remember it, right?
Waking up while intubated for surgery has to be right down there as a desirable experience, somewhere between tooth extraction without analgaesia and flying Jetstar.
It must be something of a blow to the anaesthetics profession, therefore, to read a study in which more than 10% of patients were conscious enough while under general anaesthesia to respond to commands and confirm they were in pain.
Published in the British Journal of Anaesthesia, the international multi-centre study enrolled about 340 patients aged 18-40. While they were under and intubated, but before surgery began, researchers asked them questions and tested whether they could respond to spoken commands such as “squeeze my hand” and “squeeze my hand twice if you are experiencing pain”.?
Overall 11% – 13% of women and 6% of men – responded to commands and half of those confirmed they were experiencing pain.
Mercifully those subjects had no memory of responding to the commands afterwards, although one person reported that they could clearly remember the experience of surgery.
Providing anaesthetic drugs continuously between induction of anaesthesia and intubation – which is standard in Australia – reduced the incidence of this phenomenon, known as “connected consciousness”.
“Connected consciousness” by the way … not the best choice of phrase as it connotes, well, this:
And this:
Co-author Professor Robert Sanders from the University of Sydney and Royal Prince Alfred Hospital said people should not be discouraged from seeking surgery under anaesthesia, as none of the subjects could remember the experience. He said there was “an urgent need for further research on the biological differences, particularly sex, that may influence sensitivity to anaesthetic medication”.
I suppose the question of whether it’s ok to inflict pain as long as there’s no memory of it later is one for the philosophy department.
If conscious patients are a problem for you, meanwhile, we suggest the “Dr Bob method” as outlined in this instructional video:
If you see something that makes you wake in fright, send it to penny@medicalrepublic.com.au
