As hospital traumas go, anaesthetic awareness is pretty much up there- a veritable nightmare in fact. Picture the scene: you’re on the operating table, you’ve been given a muscle relaxant and, unable to move, the surgeon’s ready to make a first incision. Problem is the anaesthetic hasn’t worked and you’re still awake.
The risk of being affected is one in 600, according to professor Michael Wang, a clinical psychologist and leading expert on the phenomenon, rising to around one in 100 for certain procedures such as cardiac surgery, where less anaesthetic is used.
It’s the basis on which the film Awake, which opened in cinemas over the weekend, hangs. Actor Hayden Christensen plays a wealthy youth with a dicky ticker who becomes conscious during heart surgery. If that really isn’t bad enough, he overhears a plot for his murder- a lucky-unlucky happenstance.
Hollywood twist aside, how realistic is the portrayal of anaesthetic awareness in the film – awake throughout, excruciating pain, full lucidity? About a third of patients suffer pain, over half experience sound and conversation and a quarter are aware of breathing tubes, according to the Royal College of Anaesthetists.
What usually happens, says Wang, is people wake after the early part of the operation once it’s well advanced and often for only short periods. Some people don’t always recall they were awake until a few days later. Longer lasting psychological effects can be devastating- post-traumatic stress disorder, phobias, chronic anxiety and flashbacks. Though strangely, many people who suffer severe psychological problems after experiencing awareness have had no pain, says Wang.
The most reliable way of avoiding awareness is the Isolated Forearm Technique, which involves tying a tourniquet around the patient’s arm, stopping the effect of muscle-relaxing drugs and allowing the patient to signal if there’s a problem.
Dreaming is very common under anaesthesia. Overhearing a murder plot- more a sign of a very active imagination.
