General anesthesia is necessary for some surgeries but it carries some well-known risks. Awake anesthesia eliminates the risks, effectively protects patients from pain and anxiety, and allows them to make a faster recovery without lingering side effects.
“For the most part, patients assume they require general anesthesia and must sleep during surgery. However, in some cases it is safer for the patient to remain awake,” says Dr. John Oyston, Chief of Anesthesiology at The Scarborough Hospital, General campus.
General anesthesia is very safe. Most people don't have serious problems from general anesthesia. This is true even for people with significant health conditions. Your risk of complications is more closely related to the type of procedure you're undergoing and your general physical health.
It is important that you get a good night's sleep before your surgery. If you find you are nervous or anxious the night before, you can take an over-the-counter sleep aid. If you are already on a nerve medication, e.g., diazepam, please contact your primary care doctor for instructions.
Although normally a patient does not remember anything about surgery that involves general anesthesia, about one or two people in every 1,000 may wake up during general anesthesia, according to the Mayo Clinic.
Coming out of general anesthesia is not the same sensation as waking up from a good night's sleep. But sometimes, after sedation, people wake up with a good feeling and interpret it as being well-rested. That's because sedative drugs can induce the release of dopamine, which gives you a sense of feeling good.
Patients frequently report having dreams during general anesthesia. The incidence of dreams during general anesthesia that have been reported by patients upon awakening has been reported to range from 10 to 36% [1] and to be higher in younger patients, female patients [2], and patients who received ketamine [3].
The process of waking up from anesthesia is known as emergence. During emergence, the anesthesiologist will slowly reduce the amount of anesthetic drugs in the body. This helps to reduce the intensity of the effects of anesthesia and allows the patient to regain consciousness.
The condition, called anesthesia awareness (waking up) during surgery, means the patient can recall their surroundings, or an event related to the surgery, while under general anesthesia. Although it can be upsetting, patients usually do not feel pain when experiencing anesthesia awareness.
You'll start feeling lightheaded, before becoming unconscious within a minute or so. The anaesthetist will stay with you throughout the procedure. They'll make sure you continue to receive the anaesthetic and that you stay in a controlled state of unconsciousness.
Waking up from anesthesia can take anywhere from a few minutes to several hours, depending on the type of anesthesia used and the individual's response to it. Generally, most people wake up within 30 minutes of the anesthesia being administered.
People might cope with pre-surgery anxiety in very different ways: Some try to prevent anxiety or stress by getting information early on and talking with other people about their concerns. Others distract themselves by reading, or use exercise or relaxation techniques like slow and deep breathing.
“There is a medication called Sevoflurane, which is a gas that we use commonly to keep patients asleep there's some increased incidence of crying when that medication is used,” said Heitz. But he suspects many factors could be involved; the stress of surgery, combined with medications and feeling slightly disoriented.
Some postoperative patients may display emotional crying. There are many reasons for emotional crying after surgery, including fear, sadness, grief, guilt, or happiness. Fear of unfamiliar surroundings and people, or fear of diagnosis, pain, or disability may precipitate emotional crying.
Failure to arouse and delayed awakening are the most common early neurologic problems following general anesthesia. True prolonged postoperative coma is relatively uncommon, with estimates ranging from 0.005 to 0.08 percent following general surgery, but with higher rates reported after cardiac surgery.
In addition to the elderly, people who have conditions such as heart disease (especially congestive heart failure), Parkinson's disease, or Alzheimer's disease, or who have had a stroke before are also more at risk. It's important to tell the anesthesiologist if you have any of these conditions.
But how long can a person be under anesthesia? The amount of time a person can remain under anesthesia depends on the type of anesthesia used and the individual's medical history. Most general anesthetics will last between 1-2 hours. However, some procedures may require longer periods of anesthesia.
Doctors must instead rely on subtle, often unreliable, methods of monitoring consciousness. For instance, increases in heart rate and blood pressure may signal to doctors that a patient is stressed and possibly awake. But drugs given before or during the operation could block the body's stress response.
Anesthesia is a drug that prevents patients from feeling pain or dramatically reduces pain during surgery or childbirth.
On the day of surgery, you may be asked to arrive several hours before your procedure is scheduled to begin. This allows the staff to complete any tests that cannot be performed until the day of surgery.
Fear of anesthesia is extremely common! In fact, according to one 2016 study, 88% of patients experience anxiety at the thought of anesthesia. Women are five times more likely to experience anxiety than men, although men are certainly not immune from this phobia.
You'll need time to recover after anesthesia. If you had local or regional anesthesia, the numb area will slowly start to feel again. You then may feel some discomfort in the area. Depending on what procedure was done and if you were sedated, you might be able to go home within a few hours.