There has been much interest by the media about the risk of being awake
during anesthesia. Additionally, with movies such as Awake starring Jessica
Alba and Hayden Christensen, the public is becoming increasingly concerned
about this potential problem.
Currently, the risk is very rare with an incidence of .1% to .2%. However, there
can be profound psychological trauma that may range from the obvious recall of
the surgery to subtle changes in behavior.
Risk factors include a history of substance abuse, chronic pain patients with
high pain medication needs, difficult placement of the breathing tube and a
history of awareness during surgery.
Additionally, the type of surgery may place you at risk. The surgeries with the
most risk are: emergency, or trauma surgery, cesarean surgery (C-section) with
general anesthesia and cardiac surgery.
Even with these additional risk factors, the incidence is still very small. To
further decrease the incidence, many hospitals are implementing brain function
monitors for the high risk patient and high risk surgery.
These brain function monitors process electroencephalographs (EEG) to a
single numerical value to reflect a depth of anesthesia.
The combination of amnestic (loss of memory) medications and the brain
function monitors can further reduce a rare but concerning risk.
Currently at St. Jude Medical Center, for high risk cases, we may use a combination of brain function monitors and a Cerebral Oximeter
for patient safety.
American Society of Anesthesia.