Patient Distress Caused by Ineffective Anesthesia

A study of 16 patients who remained awake and aware during anesthesia for surgery found that more than half developed post-traumatic stress disorder (PTSD), while none of the 10 patients who were not awake during surgery developed the disorder. The study was published in the July/August 2001 issue of General Hospital Psychiatry.

The subjects who remained aware said they were unable to communicate during their surgery and reported feeling helpless, terror, fear of pain, and pain itself. They also reported that they had felt abandoned by their doctors and nurses. In comparison, control subjects had only vague memories of their surgery and reported only mild feelings of helplessness, fear of pain, and pain. Awareness under general anesthesia is estimated to happen to 0.2 percent to 0.7 percent of U.S. surgery patients, affecting between 40,000 and 140,000 patients a year.

Most post-awareness subjects reported lapsing in and out of consciousness, picking up fragments of the surgery, conversations, and bodily sensation while struggling to move, escape, and communicate. These memories reappeared later as vivid images, sensations, isolated thoughts, and intense emotions that are characteristic of PTSD, says lead author Jane E. Osterman, M.D., M.S., of Boston University School of Medicine (MA, USA). Osterman notes that the difference between memory recall in the awareness and control subjects is consistent with previous reports showing that nontraumatic memories tend to degrade over time, while memories of traumatic events remain vivid.



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Boston University School of Medicine