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| Some patients 'wake up' during surgery | Some patients 'wake up' during surgery |
| (about 1 hour later) | |
| More than 300 people a year in the UK and Ireland report they have been conscious during surgery - despite being given general anaesthesia. | More than 300 people a year in the UK and Ireland report they have been conscious during surgery - despite being given general anaesthesia. |
| In the largest study of its kind, scientists suggests this happens in one in every 19,000 operations. | In the largest study of its kind, scientists suggests this happens in one in every 19,000 operations. |
| They found episodes were more likely when women were given general anaesthesia for Caesarean sections or patients were given certain drugs. | They found episodes were more likely when women were given general anaesthesia for Caesarean sections or patients were given certain drugs. |
| Experts say though rare, much more needs to be done to prevent such cases. | Experts say though rare, much more needs to be done to prevent such cases. |
| 'Unable to move' | 'Unable to move' |
| Led by the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland, researchers studied three million operations over a period of one year. | Led by the Royal College of Anaesthetists and Association of Anaesthetists of Great Britain and Ireland, researchers studied three million operations over a period of one year. |
| More than 300 people reported they had experienced some level of awareness during surgery. | More than 300 people reported they had experienced some level of awareness during surgery. |
| Most episodes were short-lived and occurred before surgery started or after operations were completed. But some 41% of cases resulted in long-term psychological harm. | Most episodes were short-lived and occurred before surgery started or after operations were completed. But some 41% of cases resulted in long-term psychological harm. |
| Patients described a variety of experiences - from panic and pain to choking - though not all episodes caused concern. | Patients described a variety of experiences - from panic and pain to choking - though not all episodes caused concern. |
| The most alarming were feelings of paralysis and being unable to communicate, the researchers say. | The most alarming were feelings of paralysis and being unable to communicate, the researchers say. |
| One patient, who wishes to remain anonymous, described her experiences of routine orthodontic surgery at the age of 12. | One patient, who wishes to remain anonymous, described her experiences of routine orthodontic surgery at the age of 12. |
| She said: "I could hear voices around me and I realised with horror that I had woken up in the middle of the operation but couldn't move a muscle. | She said: "I could hear voices around me and I realised with horror that I had woken up in the middle of the operation but couldn't move a muscle. |
| "While they fiddled, I frantically tried to decide whether I was about to die." | "While they fiddled, I frantically tried to decide whether I was about to die." |
| 'Rare but concerning' | 'Rare but concerning' |
| She told researchers that for 15 years after her operation she had had nightmares of monsters leaping out to paralyse her. | She told researchers that for 15 years after her operation she had had nightmares of monsters leaping out to paralyse her. |
| And it was only after she made the connection between this and her operation that the nightmares stopped. | And it was only after she made the connection between this and her operation that the nightmares stopped. |
| Each person's experience was analysed to identify factors that could make these situations more likely. | Each person's experience was analysed to identify factors that could make these situations more likely. |
| About 90% occurred when muscle-relaxant drugs - used to help paralyse muscles during surgery - were administered in combination with other drugs that normally dampen consciousness. | About 90% occurred when muscle-relaxant drugs - used to help paralyse muscles during surgery - were administered in combination with other drugs that normally dampen consciousness. |
| Researchers believe in some of these cases patients received an inappropriate balance of medication, leaving them paralysed but still aware. | Researchers believe in some of these cases patients received an inappropriate balance of medication, leaving them paralysed but still aware. |
| And there were several reports of awareness from women who had Caesarean sections while under general anaesthesia. | And there were several reports of awareness from women who had Caesarean sections while under general anaesthesia. |
| Though this type of anaesthesia is most often used in emergency situations, researchers say women should be informed of the risks. | Though this type of anaesthesia is most often used in emergency situations, researchers say women should be informed of the risks. |
| Drug errors | Drug errors |
| They calculate up to one in 670 people who have Caesarean sections with general anaesthesia could experience some levels of awareness. | They calculate up to one in 670 people who have Caesarean sections with general anaesthesia could experience some levels of awareness. |
| But experts argue this is partly due to the balance needed when achieving unconsciousness for the woman while still keeping the baby awake. | But experts argue this is partly due to the balance needed when achieving unconsciousness for the woman while still keeping the baby awake. |
| Other common factors include lung and heart operations and surgery on patients who are obese. | Other common factors include lung and heart operations and surgery on patients who are obese. |
| And some 17 cases were due to drug errors. | And some 17 cases were due to drug errors. |
| Researchers are calling for a checklist to be used at the start of operations and a nationwide approach to managing patients who have these experiences. | Researchers are calling for a checklist to be used at the start of operations and a nationwide approach to managing patients who have these experiences. |
| Prof Tim Cook, at the Royal United Hospital in Bath, who led the research, said: "For the vast majority it should be reassuring that patients report awareness so infrequently. | Prof Tim Cook, at the Royal United Hospital in Bath, who led the research, said: "For the vast majority it should be reassuring that patients report awareness so infrequently. |
| "However for a small number of patients this can be a highly distressing experience. | "However for a small number of patients this can be a highly distressing experience. |
| "I hope this report will ensure anaesthetists pay even greater attention to preventing episodes of awareness." | "I hope this report will ensure anaesthetists pay even greater attention to preventing episodes of awareness." |