Published: 23 Apr 12 12:07 CET | Print version
Online: http://www.thelocal.se/40422/20120423/
A 22-year-old Swede undergoing surgery for a collapsed lung was shocked to find himself waking up while under the knife and unable to communicate with the surgeons.
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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.
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.
Have myself frequently had to ask the dentist for a local anesthestic that would be routine elsewhere.
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!!
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.
"What does not kill me makes me stronger." - Friedrich Nietzsche
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!