Experts Agree That One Case Is Too Many; Tackle Tough Issue of Anesthesia Awareness

Saturday, December 1, 2007 General News
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NEW YORK, Nov. 30 A dynamic panel of researchers,anesthesia professionals and a patient/advocate assembled this week at a forumfor healthcare journalists to tackle the complex issue of anesthesiaawareness, the rare but devastating condition that is of heightened publicconcern due to today's release of the movie "AWAKE." The forum, "A Wake-UpCall About Anesthesia Awareness: Striking a Balance in Public Perceptions,"was convened to address the range of related challenges, controversies andconcerns in order to forge a positive path ahead to reduce anesthesiaawareness and improve patient safety.

"While AWAKE may send shockwaves through the systems of those about tohave surgery, and those who have suffered this rare event, it also serves as awake-up call to health professionals to do all we possibly can to reduce theoccurrence of anesthesia awareness," said Orin F. Guidry, MD, Professor,Anesthesia and Perioperative Medicine, Medical University of South Carolina.

ONE CASE IS TOO MANY

Anesthesia awareness occurs when a patient under general anesthesia staysor becomes conscious during surgery but can't move or talk because paralyticsare in effect. While the incidence of anesthesia awareness is rare, it canhave devastating effects. The incidence, based on several studies, is reportedto be 0.1%, which translates to about 21,000 of the 21 million people in theUnited States who receive anesthesia each year. [1]

Dr. Guidry emphasized that that dispute over the number of cases shouldnot distract from the shared sense of urgency to address the issue. "Let's getout of this box of how often it occurs. Really, one case is too many," hesaid. "As anesthesiologists, we are not going to stop until we can get thatrisk down to zero."

PATIENTS, ADVOCACY AND IMPATIENCE

Carol Weihrer, President and Founder of the Anesthesia Awareness Campaign,Inc., provided her unique perspective as a patient/advocate whose experiencewith awareness propelled her effective advocacy for patient safety andsupport. Describing her work on behalf of those, like herself, who haveexperienced this life-altering event, Ms. Weihrer said, "I am a patient, Iexperienced awareness; I am passionate; and I am impatient! It's my life'swork to direct my passion toward those who have had their lives changed bythis terrible experience."

Carol suggested that patients become more proactive both in preparationfor and in follow up after their surgery. "I encourage people to empowerthemselves with research and education about their surgery, including theanesthesia. They should have a very frank discussion with their anesthesiaprofessional in advance," continued Carol. "Always ask about monitoring, askabout paralytics, and be very forthcoming about any drugs that you aretaking."

LEVEL OF CONSCIOUSNESS MONITORS

The use of brain function monitors during surgery can reduce thelikelihood of an individual experiencing anesthesia awareness, according tothe panelists, who emphasized that these monitors are an important strategy,not a solution. "These monitors provide additional information that nothingelse in anesthesia monitoring does. I would like to see consciousness monitorsin every operating room and available for every surgery at the discretion ofthe patient and the anesthesiologist," said Daniel J. Cole, MD, Professor andChair of Anesthesiology, College of Medicine, Mayo Clinic, member of theAmerican Society of Anesthesiologists Task Force on Intraoperative Awareness.

Dr. Cole pointed to progress: "A 2005 American Society of Anesthesiologysurvey showed that 64% of anesthesiologists reported not using a brainfunction monitor. In a 2007 Stryker National Attitudes and Perceptions (SNAP)survey, 22% of those surveyed reported not using monitors. While the surveysused two different methodologies and therefore are not absolutely equivalent,this indicates t


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