MCH anesthesiologist angered by Hollywood movie
Remember how the movie Jaws made you think twice about swimming in the ocean? Well, there is a movie coming out that may make you unnecessarily concerned about undergoing surgery. The movie Awake will be out in theatres at the end of November, 2007. And it has anesthesiologists up in arms. Awake is a psychological thriller about a very, very rare occurrence called "anesthetic awareness", a phenomenon wherein a patient's failed anesthesia leaves him fully conscious but physically paralyzed during surgery. The film claims anesthetic awareness is common when in fact it almost never happens. Dr. Theresa Valois, a pediatric anesthesiologist at the Montreal Children’s Hospital of the MUHC sets the record straight.
Question: The movie – Awake -erroneously claims that anesthetic awareness is a common occurrence, but it actually happens very, very rarely. First what is anesthetic awareness and how often does it actually occur?
Answer: Anesthesia awareness is defined as the postoperative recall of events that occur during general anesthesia, in other words remembering what happen during surgery afterwards. In adults studies show it is reported to occur in 0.0068%1;2 to 0.1% of the population, in others it is lower; so out of 10,000 patients 1 may remember. In children it seems to be even more rare.
Q: Are you worried this movie will scare people so much they may forgo needed surgery?
A: No, what concerns me is worrying and scaring patients without a need, especially teenagers.
Q: Is there technology available that would alert you if a patient isn’t fully anesthetized before surgery?
A: Yes, and there is a caveat to this, this technology has been mainly validated in adults. So in children, it is not as reliable, there is no substitute for a member of the anesthesia team.
Q: What actually happens when you put someone under or anesthetize them?
A: We give medications, or gas in the veins, that have actions in different organs, like the brain, that help patients not to feel pain or remember the surgery.
Q: This movie is likely to cause a stir. What is your advice to parents of children scheduled for surgery, or anyone who might have an operation coming up?
A: Not to worry about this phenomenon, as we have said, awareness is rare and currently anesthesia is one of the safest medical specialties, and if you have any questions your anesthetist will be happy to answer them.
Q: So, it’s a lot of Hollywood hype?
A: Yes, absolutely.
Dr. Teresa Valois is a pediatric anesthesiologist at the Montreal Children’s Hospital of the MUHC.
1. Pollard RJ, Coyle JP, Gilbert RL, Beck JE: Intraoperative awareness in a regional medical system: a review of 3 years' data. Anesthesiology 2007; 106: 269-74
2. Adams AM, Smith AF: Risk perception and communication: recent developments and implications for anaesthesia. Anaesthesia 2001; 56: 745-55
Written by Lisa Dutton