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Swedish man wakes up during lung surgery

Swedish man wakes up during lung surgery

Published: 23 Apr 2012 12:07 GMT+02:00
Updated: 23 Apr 2012 12:07 GMT+02:00

“It was terrible, my worst nightmare,” the patient, from Växjö in southern Sweden, told The Local.

The man went under the knife in late March, suffering from a collapsed lung. He was fully sedated, but fifteen minutes into the surgery increased energy in his brain was registered and he had a coughing reflex. Soon after that he became aware of his surroundings and of the pain of the procedure.

The man wrote in his report to the National Board of Health and Welfare (Socialstyrelsen) that he could hear the doctors and nurses speaking and that the pain became more and more intense.

“My brain kept telling me over and over ‘say your name, say something, do something, wiggle your toes’ but I was completely incapable of saying something or moving my body at all,” the patient wrote.

He was awake for some 30-35 minutes of the 50 minute procedure. When he woke again, he was in serious pain and very angry. Despite having been promised a spinal anaesthetic to relieve some of the pain, this had not been administered.

“My first words when I woke up were ‘What the hell have you done? Hell, my back hurts, where’s the anaesthesia?’," he wrote in his report.

After the patient had explained to the doctors what he had been through, they expressed shock at the incident. He was able to retell much of what had happened during the procedure, who had said what, and what people present looked like.

Later, the anaesthetists came in to see him and he retold his experiences. After a meeting with a specialist doctor he was told that there had been some indications during the procedure that all was not quite right.

“But I never really got any explanation as to why this had happened,” the man wrote in the report.

The doctor did confirm that the man had been forced to endure considerably more pain than if he had remained sedated.

A few weeks later, the man is recovering but not free of what happened to him.

“It is still difficult on and off. It was the worst thing I could imagine. I still find it hard to sleep sometimes,” he told The Local.

Rebecca Martin

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Your comments about this article

13:38 April 23, 2012 by Galadima
I feel so sorry for the man and I pray he recovers completely. This phenomenon is called Anaesthesia Awareness. It was depicted in the 2007 movie 'Awake'.
14:06 April 23, 2012 by rohermoker
In the US he could count on a large ca$h award, In Sweden who knows?
14:26 April 23, 2012 by medicinem4n
I don't know who told this guy he would be administered spinal anesthesia, as it is totally useless for lung surgery. Spinal anesthesia anesthesizes the part of the body below the chest. As the lungs are *in* the chest cavity rather than below it, spinal anesthesia has no use in this kind of surgery.

Furthermore, spinal anesthesia is always administered *before* general anesthesia, as it requires a bit of cooperation from the patient. So there's no reason for this guy to find out that he didn't get it until *after* surgery.
15:44 April 23, 2012 by strixy
Looks like the healthcare in Sweden is getting better and better ;)
16:18 April 23, 2012 by umeåstar
What a joke! Your gonna feel pain after a surgery.. if he felt it during he would have been able to move or something. He probably felt the pressure of it. I have woken up during open heart surgery and I was able to get the attention of the doctors...I felt pressure not pain. People wake up during surgeries everywhere in the world...not just Sweden.. This dude is a wuss.. and trying to get money.
16:51 April 23, 2012 by jan.petras
Sue the anesthetist.
20:55 April 23, 2012 by johan rebel
Hey, at least he woke up, as opposed to al those who never wake up after surgery.
22:02 April 23, 2012 by krrodman
As always, these articles just don't give enough information to make a reasonable analysis but as a practicing anesthesiologist for 30 years, I am probably in the best position to talk about this case.

I am going to assume that he had a full thoracotomy for a recurrent pneumothorax(collapsed lung). Very unusual in a young person, but not unheard of. Our patient has a few facts wrong. He should have gotten an epidural preoperatively(not a spinal) in order to eliminate his pain after surgery. We do them routinely on every patient having a thoracotomy. He should have had one. I have no idea why it wasn't done.

Intraoperative awareness is a real, but rare problem in routine surgery. Put differently, intraoperative awareness is very rare in a patient who is stable enough hemodynamically to allow for a reasonable depth of anesthesia. We use EEG monitors(BIS machine) routinely to measure brain activity during surgery, but the machine is not perfect and patients have reported awareness despite the fact that the BIS tells us that the patient's brain is adequately anesthetized.

This patient's experience is typical for patients who report awareness. The patient remembers conversations and reports activity in the OR. It is also typical for patients to report psychological stress as a result of having felt pain during surgery. There is really no reason to doubt this fellow.

Without reviewing the anesthesia record it is impossible to determine if the anesthesiologist gave an adequate amount of anesthesia or not. I would also like to know if the BIS monitor is routinely used in Sweden.

Bottom line: Intraoperative awareness during routine surgery is very rare. One in thousands and thousands of patients. Frankly, it is not something I would worry about if I were scheduled for surgery. I would be much more concerned about the skill of both my surgeon and anesthesiologist.
08:04 April 24, 2012 by prince T
I am suprised dat pplle like krodman are not asking formthe race of the doctor involved. I presume krodman knows and it must have been a mistake. If it was d other way round, it will be another story.
09:23 April 25, 2012 by Flygger
@prince t Are you drunk or just unable to write a coherent sentence with correct spelling ?
11:14 April 25, 2012 by cogito
@krrodman (#9) I have heard from others that they are stingy with anesthesia in Sweden. Where in other nations an anesthetic is administered before, for example, a colonoscopy, in Sweden the patient is expected to grin and bear it.

Have myself frequently had to ask the dentist for a local anesthestic that would be routine elsewhere.
12:10 April 25, 2012 by SimonDMontfort
@cogito

They are 'stingy' with many things in Sweden!!

My experience of dealing with Swedes in a transaction, of any kind, is that you need to be aware, beforehand, of every last detail involved - because its usually a case of many many things NOT being included in the contract/price/treatment being offered.

Having said that, waking up during an operation is absolutely beyond the pale!!
16:18 April 25, 2012 by krrodman
@cogito

My experience with Swedish medicine is that they are stingy with money. I can predict accurately how Sweden will approach a medical problem. They will choose the option that entails spending the least amount of money.

You are correct when you say that in Sweden colonoscopies and upper endoscopies are performed without anesthesia. Having a colonoscopy without anesthesia feels like someone kicked you in the stomach. Uncomfortable, but nothing like having a surgical incision without anesthesia. In the States everyone gets anesthesia for these procedures at considerable expense.
02:06 April 26, 2012 by Jeff10
I've had a similar experience - once (and just once) I woke up while having sex.
15:32 April 27, 2012 by james_g
Is anesthesiologist a new word to replace anaesthetist? Syllable inflation...
17:17 April 27, 2012 by tadchem
I congratulate him. He now has a benchmark of pain that will allow him to withstand the future pains life will bring him as minor inconveniences.

"What does not kill me makes me stronger." - Friedrich Nietzsche
23:08 April 29, 2012 by Da Goat
@ Prince T

You are an idiot and not helping to dispel the evolutionary myth about some people being less evolved!

yes this poor guy is unfortunate but nothing can be done in hindsight!
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