A recent large-scale survey found that incidents of patients temporarily regaining consciousness during obstetric general anesthesia procedures are not as rare as health care providers assume.
Temporary regain of consciousness during surgery includes the sensation that the body is being cut, the inability to move the entire body, or sometimes even the accompanying sensation of pain. It is widely believed by healthcare professionals to be a rare occurrence, lasting only a few seconds to a few minutes if it happens at all, but a new survey of data shows that it occurs at a much higher rate during maternal surgery.
The recent study, published in the British Association of Anaesthesiologists’ journal Anaesthesia, showed that one in 256 people who underwent pregnancy-related surgery requiring general anaesthesia, including caesarean sections, experienced an incident in which they regained consciousness mid-surgery. This rate is much higher than the rate known from previous surveys.
According to a 2014 report by the UK National Audit Panel on Incidents of Recovery of Consciousness During Surgery (NAP5), approximately 1 in 19,000 patients undergoing general anesthesia experienced such an experience. While this rate varies depending on the type of surgery, it is still significantly lower than the rate seen in this new study.
In this new study of 3,000 women who underwent general anesthesia obstetric surgery at 72 hospitals in the United Kingdom, a total of 12 reported experiences of regaining consciousness during surgery. Seven of them (58 percent) felt anxious; five (42 percent) felt paralyzed and unable to move their bodies; and two (17 percent) felt numbness with pain. Other feelings included having their bodies pulled and stitched up and feeling difficulty breathing. These experiences are likely to cause patients to develop post-traumatic stress disorder.
Peter Odor, an anesthesiologist at University College London Hospital, who led the study, said the rate of consciousness-restoring accidents in obstetric surgery was indeed much higher than in other procedures, but he stressed that overall the technique of general anesthesia was still effective and safe.
Nuala Lucas, an obstetric anesthesiologist at Northwick Park Hospital in London, a co-investigator, said, “This is one of the largest surveys of women specifically on this phenomenon and helps to improve our understanding of the situation. We found it may be related to the anesthetic thiopentone (thiopentone) and some muscle relaxants, as well as other factors such as emergency surgery during off-hours (late hours).”
Jackie Andrade, a professor of psychology at the University of Plymouth (Plymouth University) in the United Kingdom, a co-author of the study, said, “When people experience Life-threatening or uncontrollable events, they are prone to fall into post-traumatic stress disorder. Explaining the unexpected return to consciousness during general anaesthesia and providing high-quality support can help to mitigate the psychological impact such an event can have on them.”
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