Here’s a data point. I am 65 and have had eight back surgeries under general anesthesia, and multiple sedations for colonoscopies and dental procedures. I never had any awareness whatsoever. We should all be glad we weren’t born before this stuff was invented, when you could hear screaming from the operating room half a mile away.
Yeah, doing surgery before anesthesia must have been hell for the patients. I remember hearing about how patients got heavily drunk before pulling out a tooth or something, but that might be even more back in time. Managing pain is yet another wonderful thing humanity has archived and surely will improve even further in the future.
Amateur medical historian here. Check it out: Opium as medical drug: 2100 BC Mass-produced 10% opium tincture: 1634 CE Morphine: 1820 CE Ether: 1846 CE Chloroform: 1847 CE It's a myth that there was a shortage of suitable agents prior to the 20th century. What they didn't have was mechanical ventilation or intubation of any kind, so the depth of sedation had to be maintained short of the general anesthetic level or the patient would lose their airway and die. Also there was no easy way to dose morphine for surgery, since by the time he's totally painless his lips are turning blue and they had no Narcan to reverse an overdose. Sometimes they'd mix it with a stimulant to counteract it, but it was a dicey proposition, which is why ether and chloroform were such a huge deal. Obviously anything is better than being over-sedated to the point of respiratory failure, so this often meant that an etherized patient would kick and shout unconsciously as they drifted up and down between deep and moderate sedation, with occasional flashes of auditory memory or sensation but no recollection of pain. Most US Civil War soldiers reported something similar. That meant it worked properly and they didn't suffocate him on the table, good job docs!
@@joshuahudson2170they might as well have been. When my grandmother had my mom she was given sulfa by way of a rag soaked in it as anesthesia as we now know it didn’t exist 73 years ago. She said she felt like she drank a whole case of wine afterwards.
Max is too kind to point out another reason for those comments: a number of them were obvious fabrications (like the guy who said he woke up during abdominal surgery and saw his own internal organs - that would not have been possible b/c of positioning and drapes even if he did have awareness). Some people are just storytellers looking for a captive audience.
This is very true! There's definitely a lot of attention seekers out there. I also believe it's possible that highly sedated people maybe dream about their surgeries during the days recovering post-surgery and possibly believe those things actually happened. I've had friends describe some of their surgeries as "out of body experiences" where they floated above themselves to watch the surgery. I think some people maybe have a very active sub-conscious trying to explain the changes that happened to their body that they can't remember. I had a spinal biopsy once, where I was sedated but not under anesthesia - I had absolutely no view of what was going on - and yet, in my memory I feel like I could see everything that went on. I think it's also possible, the less someone understands what's going on, the more powerful their imagination is on the subject. :D
@@kristenfrosch Yeah. I don't think it's malicious and it's often not a conscious fabrication. I think that some people invent these stories to cope with what was truly a traumatic experience for them, even without intraoperative awareness.
I think that it's very good of you and responsible to make a video that directly responds to feedback. It shows that you deserve to be in this space of educational UA-cam.
I recently had a colonoscopy and was given propofol for the procedure. It is quite amazing how quickly one completely loses awareness but what is equally as amazing is how quickly one recovers from it. Clearly this medication is a major advance in anesthesiology. These videos are outstanding btw thank you!
I’m 27 and have had over 24 surgeries starting when I was 3 years old. I have never had any problems with anesthesia or awareness/waking up and love anesthesiologists!
Another data point to add to the comment section: The last procedure I had, I was sedated. I was told very clearly that I was going to be sedated and that I wasn't going totally under, and I felt pretty uncomfortable about the prospect of being aware during the procedure. The next thing I remember after they put the warming device on me, I was being wheeled out of the room. The first thought I remember as I was being carted out was "Oh, did they cancel the procedure? Damn." Needless to say, the procedure went smoothly and I don't even remember the anesthesiologist giving me anything.
I was lightly sedated for a heart test. I was really nervous. Especially when they said the artery in my arm might not be big enough, and would have to try somewhere else. I closed my eyes, and when I opened I thought they failed and would be trying the other spot. Nope! It was already over.
The last surgery I had I came of out of sedation just as the surgeon was removing a large chunk of a lipoma. I remember saying something like “f*** eating chicken again”. Then I woke up in the recovery area. My anesthesiologist had come into my room beforehand to discuss what she was going to use. I told her that she’ll probably need to add some ketamine to the concoction along with the propofol and fentanyl. She asked me why and I pointed to my natural red hair. She said she didn’t buy into the whole ‘redheads need more anesthesia’ bit. Post surgery she came back and apologized for not listening.
She should be fired. It's scientifically proven that red heads need it. Refusing to follow best practice requires firing. I hope you filed a complaint with the medical board
I actually had the opposite experience. I woke up feeling that the surgery had been aborted because I felt like only a few minutes had passed. Of course, my six-hour surgery went very well and the anesthesiologist did a great job.
I had to get my heart tested for a kidney transplant. They said that they would try the artery in my right arm first, my left is being used for dialysis, but if they couldn't get the line through they would have to go through my groin area. I closed my eyes for what I thought was a few minutes. Since it was only light sedation I was easily woken up by their voices. It sounded like they failed, and would be going through my groin area. So I asked, but they said they were just beginning to wrap up. Best part? My heart was deemed healthy enough, and as soon as my weight gets higher, I will be put on a transplant list!
I am a physician who has had 2 surgeries in the last year with general anesthesia. I was impressed by the level of attention given to the specifics of my health and surgery when discussing the anesthesia plan and had very good results. I do remember doing an anesthesia rotation in medical school. Very interesting and a bit terrifying! I have enormous respect for anesthesia providers who can pull their knowledge and expertise together to give a good experience and keep the patient safe.
Also their timing is impeccable scheduling and administering the drugs. My last surgery I was getting prepped in one room and they started to wheel me into the OR but I was still lucid and started to worry. I almost said "hey guys, I'm still here with you"...but just as we went through the OR door I saw them add something to my drip and ...lights out!
I’m so glad you revisited this because I was one of the original people who commented about my experience with my wisdom teeth removal and at the time I totally neglected to think about the type of sedation I was receiving and how different it was from general anesthesia when I commented. I think the biggest problem was that I didn’t fully understand what would happen to begin with when I originally had them removed so it completely panicked me in the moment during the procedure as a result and because of my anxiety it caused my mind to race and overthink about it and it kind of traumatized me as a teenager as a result.
Dear Max, love your videos! They've cleared up a lot of questions I've had about many procedures from my past! I've been under every type of Anesthesia you've mentioned, for many different procedures and have all but once, had favorable results. The one time where it went poorly, (2 hour surgery) I wasn't given oxygen first (I didn't even know this was standard practice for general anesthesia until your videos) and my body broke out into a cold sweat and I felt like I was suffocating, my body did not want to fall asleep. But obviously did, probably about 10 seconds longer than expected. When told to count back from 10, I got to 0 and started to panic, (I was used to being out before getting to 6) I remember starting to tell them, my veins felt like they were burning, and I couldn't breathe and why wasn't I asleep yet, I told them it felt like something was wrong, before I fell asleep. When the surgery was done, the practice had to stay open an additional hour, because it took me too long to wake up and they didn't want the hassle of transferring me to a hospital. When I did wake, I had immediate pain and I felt like someone had hit me in the head with a hammer. I found out later, the Anesthesiologist, left 5 minutes after putting me under (for a big dental surgery at a private practice) and didn't return and there was no one to replace him. Even though, that was a bad experience - I didn't wake up during the procedure, or have memory of it. The surgery went well overall. - Throughout all my surgeries and procedures that needed anesthesia, they all went as expected. But the best time, the most skilled Anesthesiologist I remember distinctly. (was also my most recent surgery - and as an older patient, I was told this would be a risky one for me) I had a tonsillectomy and she explained everything she was going to do, why she was going to do it, made sure I understood, was friendly and made me feel comfortable. I remember her slapping my cheek gently to wake me, asking me to nod my head if I could understand, I remember her eyes smiling at me and a weird sensation of her pulling a tube out of my throat. Then nothing. I remember waking up about 15 minutes later in a recovery room. :D I felt fully awake, alert, no pain, and very comfortable. It wasn't until that surgery, did I realize anesthesia wasn't simply an "on and off switch" like I had always believed like most other people. So in all irony, I sought out your channel from a positive experience - and you were right! I never spoke about those positive experiences because it seemed crazy to be like "I LOVE A GOOD ANESTHESIOLOGIST, THEY MAKE ALL THE DIFFERENCE!" - But it's the truth. I've had over 10 surgeries, and most anesthesiologists were good - one was GREAT and the other was very "questionable." I love what you do and really appreciate you providing all this awareness. Waking up during surgery was always a great fear of mine because of that one horror movie about that and the lack of knowledge and understanding about what really goes on with your job. So, thank you for all you do and thanks to all the great anesthesiologists out there!
I completely agree and I wish I could! Unfortunately, this surgery was over 5 years ago now and I don't have any evidence outside of the record of having had the surgery and the verbal communication with the people who worked there at the time... I didn't know until recently that this was pretty much malpractice.
This was my original assumption as well, which is also why I didn't think anything more about it at the time. It was just a general lack of knowledge and naivety on my part. However, even if his reason for leaving had been an emergency - the practice should have called in someone to replace him. Rather than continue without an anesthesiologist present in the practice at all. From what I understood, he had left after 5 minutes - the surgery hadn't even begun yet. Which is gross negligence on the staff that made the conscious decision to carry out the surgery anyway. I am very fortunate there were no extreme complications. Legally, under emergency circumstances - they would have had to postpone the surgery - or find a suitable replacement in a very short amount of time. I hope you are playing devils advocate, simply for the sake of doing so - and if you were ever in that position - you'd stand up for yourself. We have systems in place to protect patients and doctors in the case of an emergency - and your life is every bit as important as whoever is on the other side of that emergency. Which is why there are protocols to be followed - and when people don't follow them - it becomes malpractice. Because our health system is very very strongly built on trust. Once you close your eyes and go under the scalpel - your life is quite literally in someone else's hands. And you should be able to trust them with your life - and that your life is just as important as everyone else's in that room.
Max! I watched the original video and a bunch of your other videos before undergoing general anesthesia for the first time and it helped alleviate my anxiety a lot. The comments freaked me out, but I wrote it up to selection bias. Needless to say, my anesthesiologist was as skilled as you are, and it was lights out and then I woke up after two hours of spine surgery with no pain, thanks to the perfect pain management. Thanks for enlightening me and for highlighting the small miracles you guys perform every day!
Anesthesia awareness under general anesthesia confirmed. Faciod,; I was oblivious thar it was even a thing. Anesthesia response: apology, labeled it awareness, told me to say I need more meds than usual. Surgeon's response? Same grievances I heard during surgery. Very recent tertiary hospital anesthesiologist response: horrified, asked me what type of therapy I received because it can be so traumatic reviewed w/me at what point during the procedure it occurred, concluded it was very likely that anesthesiologist forgot to turn on the gas. Factoid: finally understood how rare it is, it can be very traumatic, a major tenet of anesthesiology training to never have this happen
I’ve had 10 surgeries and each anesthesia experience was different for me. The closest I’ve had to “awareness” really was when I woke up to still be partially under drapes and seeing the assistant bandaging me up, but the actual surgery was over at that point.
I recently had a proximal humas fracture operation repair and waited 5 days for it as the spare parts were ordered and delivered. During the operation I became away of my arm being tugged and stretched, an implant being hammered into my arm, the sound of power tools drilling or screwing the things together and even the wound being stapled. There was no pain but an awareness. I had nightmares for months afterwards but then I am near 70 years old and have a sensitive disposition.
Hey, I had general anesthesia and I didn't remember anything 😛 The last thing I remember from before the surgery was feeling like I was drifting away down a tunnel as they had me scoot from the gurney to the operating table. The first thing I remember afterwards was someone telling either the surgeon or anesthesiologist my slightly-elevated blood sugar reading (type 1 diabetic) and me piping up to tell them to not administer any insulin for now. I wasn't in any pain, but by the time they'd come to take me out of recovery and into a normal hospital room, I was nauseous as hell, so I don't know if the anesthetics were to blame for that, or the pain killers. In contrast, after my wisdom tooth extraction, I feel like it may have taken too long to form memories again. My first memory after that one was a nurse asking me if I was still biting down on that gauze. I told her yes, then turned my attention towards my mouth, where I was surprised to find gauze packed against my gums 🙃
I’ve had a variety of levels of anesthesia for a variety of procedures. Generally I’m not aware/don’t remeber anything, even under mild sedation. The only exception was when I was undergoing a long cardiac ablation procedure back in the early 2000s. This is was catheterization procedure where I went under pretty quickly (not general anesthesia - probably moderate sedation) but due to the length of the procedure (several hours) I drifted in and out. I remember waking up and feeling the radio frequency pulses in my chest. Not pleasant, of course, and a bit weird, but not painful per se. I remember asking the anesthesiologist for more of the “juice”. They were more than happy to oblige. God bless you Max, and all your colleagues for what you do!
When I got my wisdom teeth removed (all 4 at once) my dentist actually just used local anesthetic. I agreed to let students watch and take notes of the procedure and the dentist was narrating and explaining everything he was doing. Didn't feel any pain whatsoever and had a lot of fun learning how it's done.
I've been under general anesthesia twice and it was the most uncanny experience of my entire life. One moment I'm in an operating room talking to the anesthesiologist and the next I was recovering. It was as if a light switch had been flipped... it was nothing like falling asleep and waking up.
Just to add some more anecdotal data, I’ve had surgery around 40 times or so, and the closest thing I’ve ever had to “anesthesia awareness” was once when I was waking up as the breathing tube was removed, as he referenced sometimes is necessary.
i actually conducted some research on anesthesia via general public surveys, and i don't think any of our respondents said they experienced awareness so it's def rare for sure!
It is very rare. My father DID wake up during major surgery on both lungs back in the 90s. He woke up, felt incredible pain, but could not move or speak. He remembers that one of the people in the room said "my god, he is awake!" - and he remember nothing after that.
I found this channel after searching for videos about awareness under anesthesia after I had an awareness event in surgery. So I'm definetly part of the selection bias group.
Good video man! I’ve never woke up doing surgery, I have had 14 surgeries because of my cerebral palsy, I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college to be a anesthesiologist after I graduated high school in 08 because of my cerebral palsy!
I'm another guy who has had many surgeries over the years, many as a result of a serious accident in the 1980s, who never remembers anything (yay). Multiple reconstruction surgeries of both hands, multiple ear surgeries, two eye surgeries, hernia repair, rotator cuff repair, knee repair, and prostate resection 2 months ago. Even my two colonoscopies were done under general. The last thing I remember from the recent prostate surgery is being told that I was going to get pure oxygen through the mask and the mask going on. I finally woke up as I was being wheeled into my room for the night. I remember nothing from the recovery room. I think I must be the anesthesiologist's dream patient! I subscribed and binge watched your channel after coming home from the prostate surgery. Excellent content that is very well presented.
I've had a knee replaced, several colonoscopies and both of my rotator cuffs repaired. I woke up twice during my 1st rotator cuff surgery. I woke up when the surgeon was hammering into my shoulder area. The noise right next to my left ear was annoying me so I turn my head to the left and opened my eyes. The whole room went very quiet and I went under again only to wake up again. If I had ear plugs I probably wouldn't have woken up at all. The next rotator cuff surgery I was totally out! I'm sure they made sure that wasn't going to happen again! Awesome surgeon at Northwestern - Dr. Michael Terry!
I had a cardiac ablation three days ago and was kinda relentless in expressing to the doctors how afraid I was of this happening. I've extremely grateful that I went out immediately and didn't wake up until comfortably settled in the PACU. If anything "bad" happened, I have zero memory of it, and that works just fine with me. I'm also grateful to the anesthesiologist who took my concerns with no judgment. I'll never not be afraid of anesthesia, though, because it just can't be guaranteed that this won't happen.
I've had general anesthesia 13 times now from ether (!) when I was 6 years old in 1958 for tonsils to a week ago when I had a lumbar laminectomy. Although I've never woken up during any of the procedures, my awareness varied from 'nothing, waking up in recovery' to having my ear yelled in while someone was trying to get me more alert in probably the tail end of the operating room (don't do that!) and the worst postop experience of being wheeled back to the floor after laparoscopic gallbladder surgery, being left still very groggy in a single room, down the hallway as far as possible from the nurse's station, door closed and the call button UNDERNEATH THE BED WHERE I COULDN'T GET AT IT. I puked my guts out just as my husband came into the room and grabbed a garbage can to catch it. It was pure bile and stomach contents; I have to imagine that should have been aspirated out of my stomach before I left the OR. No one came into the room to check on me for HOURS. Didn't like that surgeon at all, but he was assigned to me on a somewhat emergency basis; he seemed very flippant and show-offy. The best surgeon I ever had was for an iliectomy for Crohns disease and I could tell his staff worshipped him, for good reason. Best care ever. Still recovering from last week's laminectomy for degenerative disc disease and sciatica (cauda equina) which I let go too long hoping the symptoms would go away or at least not get worse. I was asleep two minutes after they put the midazolam in the IV, never even saw the OR but I still wonder if I was awake enough to transfer myself, or fully out by then. As I've gotten older, the anesthesia seems to work better/stronger on me; I am now 70 and want to thank all the people who have participated in my care all these years. I would have been dead long ago, otherwise. Thank you all for your dedication, this is not an easy career path by any means. Post Covid, it's more important than ever for people to consider these careers.
I have been under general several times. I know I woke up once I remember trying to open my eyes but they were taped shut. I remember someone saying she is waking up! Right after that I dont remember anything.
I was one of those people who commented on having some limited awareness under anesthesia. This VERY rare phenomenon is documented in my particular case but it is EXTREMELY rare. I also wish to add that this experience lasted only for a couple of minutes and I was neither afraid nor in ANY pain. I was not fully awake at the time either. I have undergone dozens of surgeries of various kinds before and since with no problems, and let the anesthesiologist know that I am a pain patient with a known tolerance for opiods and protocol. I regret if my EXTREMELY rare experience would cause anyone anxiety about surgery. It certainly has not caused me any trauma whatsoever.
I've had several surgeries from major to minor and never had any awareness. I've been told prior to the surgery that I will be asked questions as I'm coming out from the anaesthetic that I'll have to answer before going back onto the ward, and I don't remember any of those either! Great job to my anaesthesiologists.
I had both knees replaced and ortho dr. used an epidural and some loopy med to make me forget. I said those don't work on me in colonoscopies. He had several young male residents the day of the surgery. He was known as the cool dr. I heard hammering and drilling and watched the clock. When ever I appeared to be doing something the anesthesiologist would give me something in my IV. He came in early with those same residents the next morning and I was quoting him, "She won't remember a thing" with residents giggling. I said oh but I do remember everything. You had a hard rock concert in there that was not for me. Let me start, "you played ZZ Topp, followed by ...... My ortho surgeon's mouth flew open.
Wow. That was probably midazolam they gave you. I had that for a tooth extraction and felt surprisingly awake. Although it calmed my anxiety, the doctors were lax about numbing because they assumed I wouldn't remember it... they were wrong.
You are definitely right about people that have experienced this will most likely comment and others that haven't experienced anything unusual don't feel as inclined to comment on such video. My first surgery was a cochlear implant surgery and in this surgery I woke up and it was quite traumatic. I will not go into detail as I do have PTSD. After having this knowledge of waking up during surgery, I have always made sure I tell the anaesthetist that I have woken up during surgery and I need them to MAKE SURE that never happens again. Since that surgery I have never had any issues. I have also had surgeries including a colonoscopy under sedation and been asleep the whole time during them and even have trouble waking up from them which I find very strange!
I had a colonoscopy done a couple years ago, the anaesthesiologist looking after me made it very clear that I may have some awareness during the procedure. I only remember the first few minutes after being given the sedatives then I came to in the recovery room. Great video Max! Appreciate your attention to detail and your commitment to making factual videos.
I have had 6 back surgeries, 1 neck surgery, 1 hernia surgery, and 2 complicated oral surgeries. The only time I was aware of anything was 1st oral surgery. I became aware at end of procedure when I was being stitched up. Lidocaine had just been administered so there was no pain. The awareness was hazy at best. Before 2nd oral surgery, I relayed this to the Surgeon. He was a different Surgeon from a different practice. He said it appeared to be a situation where light sedation had been given and was just wearing off before procedure was complete. He said they would be giving moderate sedation. If I woke up before procedure was finished, more sedation would be given. They didn't want to be stitching incisions closed if I my mouth was moving around. It worked as discussed.
Another reason to love your channel. You took the time to clear up some people's confusion and further clarify and expand on the subject. I'm here for the peer reviewed data 🙌 You just made me want to write a whole paper on the subject. You're doing a great job at providing us all with free education. And for the sake of some data, I'm not here because I've had anything close to an anesthesia awareness experience. I'm here because I love learning about medical topics (and have since I was a kid). To me, the more I know, the more calm I can be in a medical emergency situation. I laughed when you were discussing how to ask questions because I just blurted out "no leading the witness" but your example was a movie. It's clear we're in different fields 😅
I’ve had general anesthesia multiple times and I’ve yet to wake up or remember anything! My memories are me saying hello to the OR nurse, the anesthesiologist, and my surgeon when he walks in, having the mask put on my face and being told to breathe normally, looking at the clock on the wall, then waking up in recovery hours later but feeling like it was only seconds, sometimes with the anesthesiologist beside me asking about my pain level.
I have severe PTSD. Normally, I have little trouble controlling it , by using several techniques. I’m concerned that under spinal or regional anesthesia (for my hip replacement), I won’t be able to control MY anxiety, and MY fearful outbursts- which can be very alarming to bystanders. What should I say to my anesthesiologist so that he can control my reactions during poor emotional regulation.? Can you be my anesthesiologist?
I've had general anaesthesia twice and in both cases I have zero recollection of anything happening from moments after I was asked to count from 10. I only watched the original video 2 days ago and this video 3 months after it was recorded. I need to watch more of your videos.
Since 1990, I have had anesthesia at least 35 times and do not recall anything. In 2019, following major ankle and foot reconstruction, the nurse anesthetist came to see me in Recovery and exclaimed about something I had said. He was called away before he could explain. He mentioned "how kind."
Something else: post-surgery memory issues. About 10 years ago I went under general twice within 24h. Both surgeries were abdo, first one scheduled, the second one urgent. Both times I remember nothing from the actual surgery. Second time I woke up and had memory issues for months and months afterwards. Very scary time in my life. I thought I was never going to regain my shortterm memory, thought I was having early onset dementia (I was in my 30's and e.g. Korsakoff was extremely unlikely). It got better with time but learning and retaining new knowledge takes more effort ever since. I don't know if it has to do with the anesthesia but I hope I never need surgery again.
I have an ex boyfriend who woke up while his appendix was being stitched up, that's the only person I've ever talked to in real life who experienced something like this. I've seen a couple of disturbing UA-cam videos, where people spoke about being fully aware during invasive surgery; from what I can tell it does happen but yes it seems very rare. BTW I've personally been under general anaesthetic 4 times, and I have responded very well each time!!
I woke up during a facelift. Didn’t feel anything, but could see the doctors hovering over me. I also remember thinking if anyone knew whether I was awake or not.
Another great video, Dr. Feinstein, thank you. I've become a critic of good anesthesia, having had so many surgeries in my lifetime. My hallmarks of a great anesthesiologist: 1. How soon they get me not caring about anything upon entering the OR. 2. And this is the most important one, IMO. HOW WELL YOU FEEL ON INITIAL CONSCIOUSNESS during recovery! Waking up in minimal discomfort, with no nausea and minimal foggy brain is awesome. If I remember being annoyed at how the recovery nurse yelled at me like I was old, senile, and deaf during initial recovery, the anesthesiologist did a great job. ; )
Namaste doctor I doyou watch your videos. I had a broken tibia and had a surgical procedure for for that nearly 6 hours. General anaesthesia was administered by spine. While I was being operated after around three hours I came into my senses completely. I could completely understand what the team of doctors we're doing the sound of electric drill saw. The anesthesiologist was completely calm, confident. She expected me to have awareness. She asked me if I was having any discomfort I replied my shoulder was numb. I categorically requested for the Ambrose to be removed she kindly acquisised. She asked me not to look at the headlight and after sometime I again went into it deep sleep. For me it was not at all traumatic. I think there are so many comments for your original video because patients get scared aur in general people get scared. I think that's the reason.
I had bilateral carpal tunnel release under moderate sedation, Propafal, and Baer blocks on the wrists. I remember suddenly waking up and feeling my arm being pulled during the second, right, release. I said to the anesthesiologist, Yo dude I'm awake. and he looked down and said "Not for long". Next thing I knew I was in recovery. There was no pain or freak out just one moment I was awake and one moment I wasn't. So no harm no foul. Had other surgeries with no issues other than scraped vocal cords after lower back surgery but I'm a big boy and I'm sure it happened while turning me on my stomach. I joked with them about getting the pregnant mommy table instead of the "motorcycle" table.
I have only ever had one procedure under general anesthesia, though I knew about it pretty well (mom has been in the medical field her entire life, and my brother's had several surgeries). So as they're putting me on the operating table, after being given whatever that drug is that makes you pretty happy and loopy, I was fully ready to count down from 10. Then I woke up, and the first thing I asked the nearest doctor was, "Did I count?" She said, "No, sweetie, you were sound asleep before we even gave you anything."
I thought I woke up in the middle of having my tonsils removed at the age of 8 for years. Now I think as soon as I received the anesthesia I wasn't completely under. I jumped up and asked, "Are my tonsils gone" the nurse smiled and said not yet sweetie you can go back to sleep.
I found that a lot of patients take "sedation" to mean they are "asleep" and completely unaware. Sedation is not the same as general anesthesia and this needs to be made very clear during pre-surgical consultation. People who come in for a knee replacement under "spinal and sedation" can be surprised to learn they are not getting general anesthesia, for example.
I had a hernia surgery, and wasnt aware, but knew that time passed longer than the stated time that the dr said it should take. NO complications other than a larger than normal hernia.
A friend had that heart test which is done in operating room to test for artery blockages , he became aware of the doctors hurting him and he wished they would stop . It turns out his heart had stopped and they were shocking him with the paddles. One doctor said let’s try a 7th time and that one restarted his heart and he didn’t remember anything more .
You can't use a defibrillator on a heart that isn't beating. Your friend either had a really vivid dream that he recalls as a false memory, or his heart didn't stop.
Have you ever had personal experience with someone that has had a patient have a reaction like Sherman Sizemore? Where a drug was forgotten or for some reason wasn’t effective and the patient had memory of surgery. While Mr. Sizemore didn’t remember on a conscious level due to benzodiazepines being used as an amnesiac. His subconscious had a full 16 minutes of the horror of being cut open during surgery. He was fully paralyzed, but not asleep. He ended up losing his mind and committing suicide 2 weeks after because his subconscious had no conscious memory to tie the extreme anxiety he was experiencing.
I definitely think communication breakdown is the biggest slice of the pie here. Many people don't know the difference between the different kinds of anesthesia, and apparently don't had them explained too well either. I think there's yet another possibility though: suggestion. Many people will either be afraid of any awareness during surgery, or their mind will try to fill in the blanks of that period they're amnestic for. There are no dreams of course during general anesthesia, but that drugged-up sleep we have in recovery or after? Yeah, your mind is missing time, you're aware of not being in your normal environment, and some meds used in anesthesia can make you loopy. Not hard to imagine how someone might not be able to discern what happened in recovery versus what actually happened in the OR, or even dreams from reality.
I had it happen once, during a dental extraction for a couple wisdom teeth that were wrapped around the jaw in a weird way and required being put under in an OR to do the surgery properly. wasn't for longer than a minute or so but unfortunately that minute was well into the surgery and was well just just say extremely unpleasant. couldn't move or do anything to alert anybody I was starting to wake up but somebody apparently noticed and the dosage was adjusted to put me back out. Found out later there were apparently some minor issues they discovered with some of the equipment they were using when they looked into what happened afterwards. I didn't make an issue out of it or anything, its just fortunate it happened with a comparatively minor surgery with me than with some car accident victim or whatever with serious injuries who could have risked serious physical or mental harm if they started coming out of it when they were being worked on
I have had 3 surgeries under a general anesthesia,a couple offers and three colonoscopies and don't recall anything after doctor gives me the count backwards signal. Usually by 8, the next thing I know is the surgery is over and I am slowly waking up in the recovery room. Just had a unilateral knee replacement in Aug and recall being moved into the table and knee moved into a device. A nurse announced Dr. X has entered the theater recording started at 10:02 and then boom, it was 12:45 and I was offered some juice in recovery.
Unfortunately I have had about 8 surgeries requiring general anesthesia. I am 70. Never had an awareness of any surgery. However, when I had a prostatectomy, there was a surgical accident whereby a minute tear occurred in my colon, successfully repaired. When I awakened, apparently my bed was next to a device that recorded a surgical professional dictating surgical notes. I heard all about the surgical accident but could not speak or move.
I was put under GA for my laparoscopic cholecystectomy.. I'm also a surgeon . I dont know what happened. But i didnt expected that this would happen to me I think i was awake.. When i felt being suffocated and unable to breath and believed i was dead that too happened three times in same operation . It felt i died three times ... Nobody Was there to save me.. i was so helpless.. when i woke up..i couldnt breath properly ... I couldnt sleeo for three days.. sleeping made me feel as if i was being buried alive. I choked . I couldnt breath.. nobody believed me what i said.. Then i researched and found about anaesthesia awareness. Now. I'm working on myself.. trying to forget this as a nightmare. I still have panic attacks...sometimes couldnt sleep... But i'm working on it . .trying to keeo myself calm.... May be its easier for me to cope with this PTSD as im a doctor too.. But sometimes .... It doesnt work... Im scared.. im just scared of ceasing to exist...and nobody believes me that this has happened to me ... Thanks to max .. atleast he believes..
This is so sad to hear. From everything I've read, when this happens, the patient almost always develops PTSD, understandably. I hope that you find the support you need to put this behind you. I also think the medical community has to be more aware of this when they see it happening to a colleague.
I had the opposite happen. When I had top surgery, I woke up thinking I dreamt the surgery. I felt like going into the OR itself was a dream. The only way I knew it happened was that I had ace bandages on my chest and I felt that my chest was totally flat!
I’ve had a few surgeries and 3 colonoscopies, the only things that came close to awareness were when I had my gallbladder removed they gave me a paralytic before they sedated me ( not sure if a mistake or if that is common?) and remember realizing I couldn’t breathe and not being able to move or tell anyone I was still awake and couldn’t breathe, while scary in the moment I believe it was just a few seconds because that’s the last thing I remember before waking up and the surgery was over and I had no awareness during the actual surgery until in the recovery room
Mine is more so wanting to be less aware going into the OR BEFORE surgery - I had 3 surgeries in two weeks after an accident. The second sx they gave me 5mg of versed pre-op...and i remember rolling into the or and then trying to decide how to move me over and i pipe up "hey i can slide myself over with my good left arm and leg". Then remember then beginning general induction. Being a RN myself my next 3 surgeries i always requested more versed because I didn't like remembering the ride into the or or induction. Lol. But, fortunately all get general anesthesia so definitely wasn't awake until I was in pacu. With my wisdom teeth removal they gave me versed and Propofol and just remember asking what he was giving me and then waking up and already in another room. Thank goodness!!
I am scheduled for knee replacement surgery March 7th. My surgeon employs the spinal block and a milder form of general anesthesia or so I understood him to say. Last time I had a spinal block, afterwards I couldn’t pee when they told me I should so they inserted a catheter. I am dreading the catheter more than I am the surgery. Can you talk to us about spinal blocks, bladder paralysis, and the need for a catheter? Thanks.
I have had two operations under general anesthesia, a gastrectomy and had my gallbladder removed and surgical hernia repaired using the same incision. I do not remember either surgery, I do remember waking up briefly in recovery and the ICU/step down unit. I’ve had other more minor surgeries done had have some recall at the time I was woken up
Only once; I became aware during an endoscopy. I tried to scream, it was so painful; they quickly said not to move or scream and turned the anesthesia further, and I remember nothing until coming to, later. It was frightening, and hopeful it never happen again!
The time that I was going under anesthesia and I was given the paralysis drug first and the meds to get me to sleep was the scariest 3-5 minutes of my life as I have this surgery every three months. I do remember some things at the end of surgery, but it was all positive and they were always telling me it’s ok I am ok etc.
Okay, so I actually had two dental procedures where I only got sedated and I don't recall a single bit of both of them. I was very happy, because I was quiet scared of the treatment I got. I had to pay for that myself though (I'm from Germany) and the bill was around 120€. The medication they used was actually written on the bill and there was Ketamine, Propofol, Fentanyl and Midazolam.
All of those are capable of causing prograde amnesia (loss of ability to form new memories) in sufficiently high doses, when used in combination this becomes a significantly more likely result. So it would make sense that some patients would completely lose the ability to form any long term memories under such sedation and thus be unable to recall any part of the experience. Even those patients that were to remember something it would likely be a fragment here or there, not a clear coherent memory of the entire experience.
Thank you! Definite difference between general anesthesia and sedation. I have never remembered anything while under general anesthesia. I won't allow for sedation because I would like to live. I have to be totally out. I refuse to have oral surgeons give me sedation. I am ok with local anesthesia in my mouth but not elsewhere.
0.1 percent is obviously small, but when there’s millions of surgeries with people under general anesthesia, that’s still tens or even hundreds of thousands surgeries with awareness
I had conscious sedation for dental work, and though I don’t remember much, it ultimately didn’t work on me because I was awake enough for my gag reflex to get in the way of it all. I do remember hearing someone say ‘I can’t keep the bite block in her mouth’, and that’s it. I don’t remember feeling any certain way, physically or mentally. Then it was determined that general anesthesia was the best option for me. I remember an anesthesiologist putting the IV in. She was asking me if I had any pets, and I was answering her. I suddenly felt a bit light headed and saying I needed to close my eyes. The next thing I remember was hearing someone calling my name and saying that the work was done and it all went well, then asking how I felt. It literally felt like I closed my eyes, dozed off, and then woke up again. No pain, no memory, a very pleasant experience considering what was going on! There’s a lot of misinformation about the differences in types of sedation, and I think your videos do a wonderful job at clarifying and putting minds at ease!
In the UK, gastroscopy and colonoscopy are now commonly undertaken without even sedation. As a 9-year-old in 1971, I experienced awareness under general anaesthesia for dental extraction. I was induced with Brietal (Methohexitone) and thereafter maintained on oxygen and nitrous oxide, no volatile, and intermittent boluses of more Methohexitone. Back then, there were no vital signs monitoring devices in dental practices - just observation of PPP (pulse, pallor, pupil). Pulse oximeters had yet to be invented.
A funny thing that happened when I had oral surgery for wisdom tooth extraction many years ago. After the surgery, the oral surgeon asked if I remembered anything. I remembered some sensation of pressure-- no pain, no awareness of what was happening--just some feeling of pressure. The surgeon said that I got the hiccups during the surgery and they had to bring me up just a bit to control the hiccups. I would not even call this being aware under anesthesia or sedation, I was feeling no pain or anxiety. I was not even conscious enough to think about it, just a feeling of pressure.
Well as a counter to selection bias when I had a procedure under a general anaesthetic last week I didn't even get a far as remembering them actually administering any medication. I remember being wheeled into the pre-op anaesthesia room, I remember them putting the canula in and telling me they were about to administer the medication, then I was in the recovery room. I do not even remember them connecting the medication to the canula let alone administering it. But then I guess that blocking the ability to form new memories probably causes a little retrograde amnesia during induction as the short term memories from the last few minutes wont have been committed to long term memory yet and thus never will as the medication inhibits that process.
I had general this past September for a foreign object removal via upper endoscopy (accidentally swallowed something during an orthodontic procedure- BTW, ask your GI doctor what the most unusual things are that she/he has pulled out of peoples stomachs- I guarentee they have a list). I remember only one thing, and it probably happened while I was waking up- I could have sworn that I dreamed while under. Like I said, it was probably while waking up but before forming new memories (or while that was starting up) or I took a little nap between the anesthesia being discontinued and my fully waking in the recovery area. I remember thinking,” Wow! You dream while under general anesthesia! Cool!” Probably not, but it certainly was interesting.
I remember being aware of being extubated after one of my surgeries. Later that day, I had no memory of the procedure but definitely remembered being aware-rather than having the memory of the experience, I remember being aware of the experience. I suspect even if I were to experience anesthesia awareness, I would have no recollection of the event unless anesthesia was already stopped and my brain was already on the edge of being able to form new memories.
I’m a recovery nurse and knowing the patient is extubated in the operating room they wake up groggy and see bright lights, lots of staff including the surgeon and maybe feel pain, they often drift back to sleep on transfer to the recovery room and when they wake fully in a different area recall the waking experience and think they woke up during their surgery. Luckily the majority of my patients don’t recall waking during extubation!
i remember waking up during extubation and gagging, while someone was saying my name, and that they were all done with my surgery. i mustve fallen back asleep, because i dont remember being wheeled to recovery.
I had 4 surgeries on my right knee. They were general anesthesia. The 5th was also general, I made it into the operating room while still awake, strapped down as if being crucified, then after a bit fell asleep. The 6th time having total knee replacement I told the anesthesia guy, and remember leaving preop
Hello Dr. Feinstein. I haven't, to my knowledge, had a period of awareness from general anesthesia, and I've been under general a few times. I have had one period of awareness while under deep twilight sedation for a cardiac catheter procedure. I was aware of, but not remembering the conversations that the staff was having. I did start to come up out of it before they were done, as I remember feeling this grating abrading feeling in my left arm when they moved the catheter. I don't know if I actually said the words "I felt that", or just mumbled something incomprehensible, but I do distinctly remember the doctor saying "He's still awake!" in kind of an "Oh ####" tone of voice, and then the next thing I remembered was being wheeled out of the cath lab to recovery area.
I woke up from GA crying my eyes out but not knowing why. I don't know what to make of it. Maybe I did have some awareness during surgery, but I forgot it all like how a dream often disappears from memory when you wake up.
A friend of mine bursts into tears every time she wakes up from any amount of anaesthesia, she's never remembered any of her procedures it's just a physical reaction her body has to the medication
I am a dentist that offers moderate anesthesia care and very much enjoy your videos. In this episode you commented that viewers of a previous episode referenced "waking up" while having wisdom teeth removed. The reason (problem) is nomenclature. About 15-18 years ago, the American Dental Association (like most professional organizations) adopted the ASA's nomenclature for anesthesia. There are four states: two conscious (minimal and moderate) and two unconscious (deep sedation and GA). That is the nomenclature we are "supposed" to be using. However, unlike medicine where physicians are responsive to their professional organization (specialty board), dentists are responsible directly to the state (ie state dental board). Unfortunately, as a very small cog in a state's bureaucracy, state dental boards are very slow to respond to change. While state dental boards may offer a variety of permits for different techniques for minimal and moderate sedation, they typically "lump" any unconscious state of anesthesia (deep sedation and GA) together into a permit called "General Anesthesia." This permit is only open to dentists that have completed an oral and maxillofacial surgery residency (5 years) or a dental anesthesia residency (3 years). From a patient safety standpoint, this works fine; it isolates rendering a patient unconscious to only be treated by providers with years of formal post-dental school experience. Unfortunately, it is technically a misuse of the phrase, "General Anesthesia." I do not know of any oral surgeon that is truly providing GA for wisdom teeth removal; they are actually providing "deep sedation." Even those that choose to intubate a patient are still using local anesthetics, so the patient is really "deeply sedated," not under GA. HOWEVER, everyone in dentistry refers to what oral surgeons do as "GA" because that is what the license is called. Yes, we're part of the problem but I don't see it changing soon.
Had anesthesia for dental surgery and couldn't feel a thing but was aware of what was happening. However, the reaction to the anesthesia was troubling. I cried and cried and cried. No pain but is sure did get the staff very worried. The cry jags lasted for a few weeks at odd times but still there was no pain or reason so cry.
I think coming out of anasthesia is what people are getting confused about. I remember someone saying "one polyp removed right" but don't remember being moved to recovery. Came out really fast though. Going to sleep was very odd though lol.
It was 40 years ago during a “crash” induction for a c-section for hypertension. I understand my BP was very labile. I don’t remember being intubated but do have some recall of significant pain without being able to move, shortly thereafter. I’ve heard this story from others but, again, 40 years ago….
Hey, Doctor Max, another great vid! I've had an unfortunate number of procedures in the past 10 years. Due to previous issues with sedation, I always, always demand general anesthesia regardless of the "routine" or "typical" practice. Anesthesiologists are always understanding, given my history with sedation. I had only a single instance where they stated they could not give a general for angioplasty and stenting of the common iliac artery. With that one, the sedation once again failed and I have total recall of the entire 2 1/2 hours on the table. I had one procedure where the proceduralist got in a hurry and began the procedure before the CRNA had me fully induced. That was a horrible experience. In ll other general anesthesia procedures - including colonoscopies - I have zero recall. I will never again have an angioplasty, or any other significant procedure if they can't use general anesthesia, given my terrible experiences with sedation.
I had left a comment about waking up during a procedure on the previous video. I should clarify that it was an endoscopy followed by colonoscopy looking for bleeding and I had asked that they bring me up in sedation level during the colonoscopy so I would be more alert during the post op review with the doctor. I was not at all upset that I was alert when they found and marked the tumor, and not unacceptably uncomfortable. The surgeon who came in to consult with the Doctor performing the colonoscopy was the one that was later freaked out that I was alert and remembered. He had a colonoscopy coming up himself want really wanted to make sure he wouldnt remember any of it. I thought my anesthesiologist did a great job threading the needle and keeping me comfortable, but fully alert by the end of the procedure so I could digest the news.
@K Mine was when they located the tumor on my far right side, so midway through the procedure. The die injection into the tumor was a little uncomfortable, but ok. That scope tube feels like a garden hose though!
@K I was just glad they found out why I was bleeding internally. On the funny side, they did the endoscopy first so they gave me something to relax me that was awesome. Then the nurses stuck this bit in my mouth so I couldnt bite the tube I guess. I was like, hey didnt I see this in pulp fiction, there isnt a gimp coming in, is there. They started laughing and the anesthesiologist said, yep thats enough, hit a plunger and I was out. 🤣
@K I just had my 3rd, and I think it gets easier each time. Just try and relax and talk to you nurse and anesthesiologist. They really want you to have a positive experience. My last one was just a month ago, my 4 year post cancer surgery check. They were super good about addressing my concerns. My 2nd endoscopy was an emergency gallbladder procedure. That one they just hammered me out and I remember nothing but seeing the Doctor and apologizing for ruining his evening. Then nothing. Ill keep you in my thought and again, if they know you are worried they usually treat you extra gently.
In some countries it's not uncommon for wisdom teeth removal to be done by a maxillofacial surgeon under general anaesthesia. I had my wisdom teeth removed under general anaesthesia in a hospital (Australia) because it was a complex case due to one of the teeth being impacted and very close to my facial nerve, I didn't have any awareness during it though. Including the wisdom teeth surgery, I've had 3 surgeries under general anaesthesia and had 0 awareness or recall from any of them. All 3 I remember pretty much the same way: I start counting down from 10 and get to like, 7 or 6, and then wake up in recovery violently shivering. I dunno why I always feel *so* cold after anaesthesia, but the blankets from the blanket warmer are the best thing ever and make up for it. I've also had one procedure done under what they called "twilight sedation", which I'm pretty sure was just propofol. I was warned I might have some awareness and may remember some things, but thankfully I also don't remember anything from that procedure, though apparently I was conscious enough to attempt to talk to the doctor and nurses lol
Must be nice because that’s definitely not how it is in France! 😂 I just got a shot in the gums and then the twisting and pulling began! And yes, it hurt a whole lot still!
Wait some people forget everything when under sedation, I've never forgot anything under sedation, I thought it was just to numb the pain a little. Saying that I've been conscious and fought against surgeons (leaving lots of nicks and cuts where they shouldn't be) under general anaesthesia but have no memory of it. Local anaesthesia also doesn't work on me (it has a mild effect but no more than slapping the skin does), when a nurse was stitching my head after a fall she pumped all the local anaesthesia in she could and I said I still feel it, she said that's not possible and she had used as much as she could, I told her to carry on regardless as I needed the stitched, I then proceeded to close my eyes and talked her through every stitch in and out, when I opened my eyes all the colour had drained out of her face and she looked visibly shocked.
I have false memories from a time under, what I believe was general anesthesia. I was about 5 years old and having laser eye surgery on my retina. Adults can do this surgery fully awake with no sedation, which I later did, and it isn't very painful. However, children cannot be expected to sit still with a powerful laser being shot into their eye. I remember them putting the gas mask on and me not liking the smell of the gas. Then I remember us somehow deciding not to do the surgery and going back to the waiting room to wait for the time that the surgery would have taken. I then remember waking up in the recovery room. Obviously, the surgery had actually happened. Perhaps some of the people commenting also have false memories that are simply much more accurate to what actually happened. As a child, I didn't know what would happen, but as an adult, I will generally know a bit about what will happen before a surgery and have the knowledge necessary to fabricate a decently accurate false memory.
I was terrified this would happen to me when I had surgery, and instead I woke up after the surgery in insane pain, but they wouldn't do anything to help me and kept telling me it was all in my head or something. They thought they were controlling my pain with benzodiazapines that didn't work on me because I used to take them for over a decade and was in active benzo withdrawal syndrome at the time. I tried to climb off the table so they gave me something to put me under pretty quick after that.
Wait, so if GA is the only form of sedation you would expect no awareness with recall from, does that mean it's not unexpected from spinal and sedation? Because it's really common to use that for hip and knee replacements here and I cannot imagine how traumatic it would be to wake up whilst having my hip removed!
Remember being aware during the surgery done not mean being in pain. I was a circulating nurse in the OR. The level of sedation is unique to each patient. Some are fairly awake and may talk some others are mostly napping when using sedation and regional anesthesia and this is explained to them before surgery so it's not a surprise.
the operation I had, and I woke up in the middle of the operation were back in the early 80's. Gee, that is like 40 years ago? I take it that the craft has gotten better over the years.
During a heart ablation, which was not general anesthesia but through an IV, a kink got in the IV and I woke up. Nothing hurt, I was just irritated at the time because my face was covered and I was hot, plus my arms were tied down. They put me right back under. Later I asked if this happened and the anesthesiologist said it had. By that time I wasn't upset because all went well...plus it makes a great life story.😁 No harm done.
I recently had shoulder surgery. After getting wheeled into the O.R., the anesthesiologist told me he was going to give me my first med. I remember acknowledging. The next thing I knew, I was waking up and the surgeon was telling me how everything went and what he found. Oddly, some of the things he told me he was going to do first - having me breathe pure oxygen, etc - I have no recall of. Maybe I'm just a light weight and the first meds made me fall asleep faster than expected.
Same - I feel like a lightweight because I don't remember anything after I was started on midazolam. It was 4 minutes later that my chart shows they started the next round of drugs but I was 100% out a few seconds after after I heard "I starting you on the first drug that should ease your mind a bit" - next thing I knew, I was waking up in the PACU lol
To me its crazy how people get sedated for wisdom tooth extractions in the US. Here in Finland thats very rare, you get injected with analgesic in the gum (which works very well) and no sedation. Only if its required because of excess inflammation, or nerves or whatever. I had a wisdom tooth extracted with just pain killer, I didnt feel a thing but was perfectly awake and aware. The extraction itself took like 10 seconds at most, then a few minutes of stitching up and all done.
Here’s a data point. I am 65 and have had eight back surgeries under general anesthesia, and multiple sedations for colonoscopies and dental procedures. I never had any awareness whatsoever. We should all be glad we weren’t born before this stuff was invented, when you could hear screaming from the operating room half a mile away.
Yeah, doing surgery before anesthesia must have been hell for the patients. I remember hearing about how patients got heavily drunk before pulling out a tooth or something, but that might be even more back in time. Managing pain is yet another wonderful thing humanity has archived and surely will improve even further in the future.
@@Kitsudote Yeah; because blackout drunk worked and was available very far back.
Amateur medical historian here. Check it out:
Opium as medical drug: 2100 BC
Mass-produced 10% opium tincture: 1634 CE
Morphine: 1820 CE
Ether: 1846 CE
Chloroform: 1847 CE
It's a myth that there was a shortage of suitable agents prior to the 20th century. What they didn't have was mechanical ventilation or intubation of any kind, so the depth of sedation had to be maintained short of the general anesthetic level or the patient would lose their airway and die. Also there was no easy way to dose morphine for surgery, since by the time he's totally painless his lips are turning blue and they had no Narcan to reverse an overdose. Sometimes they'd mix it with a stimulant to counteract it, but it was a dicey proposition, which is why ether and chloroform were such a huge deal.
Obviously anything is better than being over-sedated to the point of respiratory failure, so this often meant that an etherized patient would kick and shout unconsciously as they drifted up and down between deep and moderate sedation, with occasional flashes of auditory memory or sensation but no recollection of pain. Most US Civil War soldiers reported something similar. That meant it worked properly and they didn't suffocate him on the table, good job docs!
@@joshuahudson2170they might as well have been. When my grandmother had my mom she was given sulfa by way of a rag soaked in it as anesthesia as we now know it didn’t exist 73 years ago. She said she felt like she drank a whole case of wine afterwards.
Yup....anyone remember Either? Disgusting during and after....Oh and as a extra treat it was flammable as hell...
Max is too kind to point out another reason for those comments: a number of them were obvious fabrications (like the guy who said he woke up during abdominal surgery and saw his own internal organs - that would not have been possible b/c of positioning and drapes even if he did have awareness). Some people are just storytellers looking for a captive audience.
This is very true! There's definitely a lot of attention seekers out there. I also believe it's possible that highly sedated people maybe dream about their surgeries during the days recovering post-surgery and possibly believe those things actually happened. I've had friends describe some of their surgeries as "out of body experiences" where they floated above themselves to watch the surgery. I think some people maybe have a very active sub-conscious trying to explain the changes that happened to their body that they can't remember.
I had a spinal biopsy once, where I was sedated but not under anesthesia - I had absolutely no view of what was going on - and yet, in my memory I feel like I could see everything that went on.
I think it's also possible, the less someone understands what's going on, the more powerful their imagination is on the subject. :D
@@kristenfrosch Very interesting observation and theory, makes a lot of sense to me.
Aaaqaq😅 2:56 😅
That was my first thought. Some people might feel the need to follow along, and some just like to fuel fires.
@@kristenfrosch Yeah. I don't think it's malicious and it's often not a conscious fabrication. I think that some people invent these stories to cope with what was truly a traumatic experience for them, even without intraoperative awareness.
I think that it's very good of you and responsible to make a video that directly responds to feedback. It shows that you deserve to be in this space of educational UA-cam.
I recently had a colonoscopy and was given propofol for the procedure. It is quite amazing how quickly one completely loses awareness but what is equally as amazing is how quickly one recovers from it.
Clearly this medication is a major advance in anesthesiology.
These videos are outstanding btw thank you!
There was a similar agent before Propofol but it was more difficult to use.
@@wholeNwon Dilaudid?
@@kendallevans4079 No. Brevital.
I’m 27 and have had over 24 surgeries starting when I was 3 years old. I have never had any problems with anesthesia or awareness/waking up and love anesthesiologists!
Another data point to add to the comment section: The last procedure I had, I was sedated. I was told very clearly that I was going to be sedated and that I wasn't going totally under, and I felt pretty uncomfortable about the prospect of being aware during the procedure.
The next thing I remember after they put the warming device on me, I was being wheeled out of the room. The first thought I remember as I was being carted out was "Oh, did they cancel the procedure? Damn."
Needless to say, the procedure went smoothly and I don't even remember the anesthesiologist giving me anything.
I was lightly sedated for a heart test. I was really nervous. Especially when they said the artery in my arm might not be big enough, and would have to try somewhere else. I closed my eyes, and when I opened I thought they failed and would be trying the other spot. Nope! It was already over.
The last surgery I had I came of out of sedation just as the surgeon was removing a large chunk of a lipoma. I remember saying something like “f*** eating chicken again”. Then I woke up in the recovery area. My anesthesiologist had come into my room beforehand to discuss what she was going to use. I told her that she’ll probably need to add some ketamine to the concoction along with the propofol and fentanyl. She asked me why and I pointed to my natural red hair. She said she didn’t buy into the whole ‘redheads need more anesthesia’ bit. Post surgery she came back and apologized for not listening.
She should be fired. It's scientifically proven that red heads need it. Refusing to follow best practice requires firing. I hope you filed a complaint with the medical board
I actually had the opposite experience. I woke up feeling that the surgery had been aborted because I felt like only a few minutes had passed. Of course, my six-hour surgery went very well and the anesthesiologist did a great job.
That is how it was for my cancer surgery. just a blink in time.
This is exactly what should happen. You make no new memories so for you it was literally seconds ago.
I had to get my heart tested for a kidney transplant. They said that they would try the artery in my right arm first, my left is being used for dialysis, but if they couldn't get the line through they would have to go through my groin area. I closed my eyes for what I thought was a few minutes. Since it was only light sedation I was easily woken up by their voices. It sounded like they failed, and would be going through my groin area. So I asked, but they said they were just beginning to wrap up. Best part? My heart was deemed healthy enough, and as soon as my weight gets higher, I will be put on a transplant list!
I am a physician who has had 2 surgeries in the last year with general anesthesia. I was impressed by the level of attention given to the specifics of my health and surgery when discussing the anesthesia plan and had very good results. I do remember doing an anesthesia rotation in medical school. Very interesting and a bit terrifying! I have enormous respect for anesthesia providers who can pull their knowledge and expertise together to give a good experience and keep the patient safe.
Also their timing is impeccable scheduling and administering the drugs. My last surgery I was getting prepped in one room and they started to wheel me into the OR but I was still lucid and started to worry. I almost said "hey guys, I'm still here with you"...but just as we went through the OR door I saw them add something to my drip and ...lights out!
I’m so glad you revisited this because I was one of the original people who commented about my experience with my wisdom teeth removal and at the time I totally neglected to think about the type of sedation I was receiving and how different it was from general anesthesia when I commented. I think the biggest problem was that I didn’t fully understand what would happen to begin with when I originally had them removed so it completely panicked me in the moment during the procedure as a result and because of my anxiety it caused my mind to race and overthink about it and it kind of traumatized me as a teenager as a result.
Dear Max, love your videos! They've cleared up a lot of questions I've had about many procedures from my past! I've been under every type of Anesthesia you've mentioned, for many different procedures and have all but once, had favorable results.
The one time where it went poorly, (2 hour surgery) I wasn't given oxygen first (I didn't even know this was standard practice for general anesthesia until your videos) and my body broke out into a cold sweat and I felt like I was suffocating, my body did not want to fall asleep. But obviously did, probably about 10 seconds longer than expected. When told to count back from 10, I got to 0 and started to panic, (I was used to being out before getting to 6) I remember starting to tell them, my veins felt like they were burning, and I couldn't breathe and why wasn't I asleep yet, I told them it felt like something was wrong, before I fell asleep.
When the surgery was done, the practice had to stay open an additional hour, because it took me too long to wake up and they didn't want the hassle of transferring me to a hospital. When I did wake, I had immediate pain and I felt like someone had hit me in the head with a hammer. I found out later, the Anesthesiologist, left 5 minutes after putting me under (for a big dental surgery at a private practice) and didn't return and there was no one to replace him. Even though, that was a bad experience - I didn't wake up during the procedure, or have memory of it. The surgery went well overall.
-
Throughout all my surgeries and procedures that needed anesthesia, they all went as expected. But the best time, the most skilled Anesthesiologist I remember distinctly. (was also my most recent surgery - and as an older patient, I was told this would be a risky one for me) I had a tonsillectomy and she explained everything she was going to do, why she was going to do it, made sure I understood, was friendly and made me feel comfortable. I remember her slapping my cheek gently to wake me, asking me to nod my head if I could understand, I remember her eyes smiling at me and a weird sensation of her pulling a tube out of my throat. Then nothing. I remember waking up about 15 minutes later in a recovery room. :D I felt fully awake, alert, no pain, and very comfortable.
It wasn't until that surgery, did I realize anesthesia wasn't simply an "on and off switch" like I had always believed like most other people. So in all irony, I sought out your channel from a positive experience - and you were right! I never spoke about those positive experiences because it seemed crazy to be like "I LOVE A GOOD ANESTHESIOLOGIST, THEY MAKE ALL THE DIFFERENCE!"
-
But it's the truth. I've had over 10 surgeries, and most anesthesiologists were good - one was GREAT and the other was very "questionable." I love what you do and really appreciate you providing all this awareness. Waking up during surgery was always a great fear of mine because of that one horror movie about that and the lack of knowledge and understanding about what really goes on with your job.
So, thank you for all you do and thanks to all the great anesthesiologists out there!
if you can you should talk to a lawyer about possibly suing the anesthesiologist that left you unattended
I completely agree and I wish I could! Unfortunately, this surgery was over 5 years ago now and I don't have any evidence outside of the record of having had the surgery and the verbal communication with the people who worked there at the time... I didn't know until recently that this was pretty much malpractice.
@@kristenfrosch To be fair, they may have been called in for an emergency or something. You don't know the other side of it.
This was my original assumption as well, which is also why I didn't think anything more about it at the time. It was just a general lack of knowledge and naivety on my part. However, even if his reason for leaving had been an emergency - the practice should have called in someone to replace him. Rather than continue without an anesthesiologist present in the practice at all. From what I understood, he had left after 5 minutes - the surgery hadn't even begun yet. Which is gross negligence on the staff that made the conscious decision to carry out the surgery anyway. I am very fortunate there were no extreme complications. Legally, under emergency circumstances - they would have had to postpone the surgery - or find a suitable replacement in a very short amount of time.
I hope you are playing devils advocate, simply for the sake of doing so - and if you were ever in that position - you'd stand up for yourself. We have systems in place to protect patients and doctors in the case of an emergency - and your life is every bit as important as whoever is on the other side of that emergency. Which is why there are protocols to be followed - and when people don't follow them - it becomes malpractice. Because our health system is very very strongly built on trust. Once you close your eyes and go under the scalpel - your life is quite literally in someone else's hands. And you should be able to trust them with your life - and that your life is just as important as everyone else's in that room.
Hindsight is always 20/20 Haha :,D
Max! I watched the original video and a bunch of your other videos before undergoing general anesthesia for the first time and it helped alleviate my anxiety a lot. The comments freaked me out, but I wrote it up to selection bias. Needless to say, my anesthesiologist was as skilled as you are, and it was lights out and then I woke up after two hours of spine surgery with no pain, thanks to the perfect pain management. Thanks for enlightening me and for highlighting the small miracles you guys perform every day!
Anesthesia awareness under general anesthesia confirmed.
Faciod,; I was oblivious thar it was even a thing.
Anesthesia response: apology, labeled it awareness, told me to say I need more meds than usual.
Surgeon's response? Same grievances I heard during surgery.
Very recent tertiary hospital anesthesiologist response: horrified, asked me what type of therapy I received because it can be so traumatic reviewed w/me at what point during the procedure it occurred, concluded it was very likely that anesthesiologist forgot to turn on the gas.
Factoid: finally understood how rare it is, it can be very traumatic, a major tenet of anesthesiology training to never have this happen
I’ve had 10 surgeries and each anesthesia experience was different for me. The closest I’ve had to “awareness” really was when I woke up to still be partially under drapes and seeing the assistant bandaging me up, but the actual surgery was over at that point.
I recently had a proximal humas fracture operation repair and waited 5 days for it as the spare parts were ordered and delivered. During the operation I became away of my arm being tugged and stretched, an implant being hammered into my arm, the sound of power tools drilling or screwing the things together and even the wound being stapled. There was no pain but an awareness. I had nightmares for months afterwards but then I am near 70 years old and have a sensitive disposition.
Hey, I had general anesthesia and I didn't remember anything 😛
The last thing I remember from before the surgery was feeling like I was drifting away down a tunnel as they had me scoot from the gurney to the operating table. The first thing I remember afterwards was someone telling either the surgeon or anesthesiologist my slightly-elevated blood sugar reading (type 1 diabetic) and me piping up to tell them to not administer any insulin for now. I wasn't in any pain, but by the time they'd come to take me out of recovery and into a normal hospital room, I was nauseous as hell, so I don't know if the anesthetics were to blame for that, or the pain killers.
In contrast, after my wisdom tooth extraction, I feel like it may have taken too long to form memories again. My first memory after that one was a nurse asking me if I was still biting down on that gauze. I told her yes, then turned my attention towards my mouth, where I was surprised to find gauze packed against my gums 🙃
I’ve had a variety of levels of anesthesia for a variety of procedures. Generally I’m not aware/don’t remeber anything, even under mild sedation. The only exception was when I was undergoing a long cardiac ablation procedure back in the early 2000s. This is was catheterization procedure where I went under pretty quickly (not general anesthesia - probably moderate sedation) but due to the length of the procedure (several hours) I drifted in and out. I remember waking up and feeling the radio frequency pulses in my chest. Not pleasant, of course, and a bit weird, but not painful per se. I remember asking the anesthesiologist for more of the “juice”. They were more than happy to oblige. God bless you Max, and all your colleagues for what you do!
When I got my wisdom teeth removed (all 4 at once) my dentist actually just used local anesthetic. I agreed to let students watch and take notes of the procedure and the dentist was narrating and explaining everything he was doing. Didn't feel any pain whatsoever and had a lot of fun learning how it's done.
i find it absolutely amazing how every single one of your videos is interesting, informative and engaging. what a rarity, keep up the great work!
I've been under general anesthesia twice and it was the most uncanny experience of my entire life. One moment I'm in an operating room talking to the anesthesiologist and the next I was recovering. It was as if a light switch had been flipped... it was nothing like falling asleep and waking up.
Just to add some more anecdotal data, I’ve had surgery around 40 times or so, and the closest thing I’ve ever had to “anesthesia awareness” was once when I was waking up as the breathing tube was removed, as he referenced sometimes is necessary.
i actually conducted some research on anesthesia via general public surveys, and i don't think any of our respondents said they experienced awareness so it's def rare for sure!
It is very rare. My father DID wake up during major surgery on both lungs back in the 90s. He woke up, felt incredible pain, but could not move or speak. He remembers that one of the people in the room said "my god, he is awake!" - and he remember nothing after that.
I found this channel after searching for videos about awareness under anesthesia after I had an awareness event in surgery. So I'm definetly part of the selection bias group.
Good video man! I’ve never woke up doing surgery, I have had 14 surgeries because of my cerebral palsy, I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college to be a anesthesiologist after I graduated high school in 08 because of my cerebral palsy!
Do you still suffer from it
@@skyhappy yes I was born with it
@@skyhappy It’s a lifelong inpatient.
I'm another guy who has had many surgeries over the years, many as a result of a serious accident in the 1980s, who never remembers anything (yay). Multiple reconstruction surgeries of both hands, multiple ear surgeries, two eye surgeries, hernia repair, rotator cuff repair, knee repair, and prostate resection 2 months ago. Even my two colonoscopies were done under general.
The last thing I remember from the recent prostate surgery is being told that I was going to get pure oxygen through the mask and the mask going on. I finally woke up as I was being wheeled into my room for the night. I remember nothing from the recovery room.
I think I must be the anesthesiologist's dream patient!
I subscribed and binge watched your channel after coming home from the prostate surgery. Excellent content that is very well presented.
I've had a knee replaced, several colonoscopies and both of my rotator cuffs repaired. I woke up twice during my 1st rotator cuff surgery. I woke up when the surgeon was hammering into my shoulder area. The noise right next to my left ear was annoying me so I turn my head to the left and opened my eyes. The whole room went very quiet and I went under again only to wake up again. If I had ear plugs I probably wouldn't have woken up at all. The next rotator cuff surgery I was totally out! I'm sure they made sure that wasn't going to happen again! Awesome surgeon at Northwestern - Dr. Michael Terry!
I had a cardiac ablation three days ago and was kinda relentless in expressing to the doctors how afraid I was of this happening. I've extremely grateful that I went out immediately and didn't wake up until comfortably settled in the PACU. If anything "bad" happened, I have zero memory of it, and that works just fine with me. I'm also grateful to the anesthesiologist who took my concerns with no judgment. I'll never not be afraid of anesthesia, though, because it just can't be guaranteed that this won't happen.
I've had general anesthesia 13 times now from ether (!) when I was 6 years old in 1958 for tonsils to a week ago when I had a lumbar laminectomy. Although I've never woken up during any of the procedures, my awareness varied from 'nothing, waking up in recovery' to having my ear yelled in while someone was trying to get me more alert in probably the tail end of the operating room (don't do that!) and the worst postop experience of being wheeled back to the floor after laparoscopic gallbladder surgery, being left still very groggy in a single room, down the hallway as far as possible from the nurse's station, door closed and the call button UNDERNEATH THE BED WHERE I COULDN'T GET AT IT. I puked my guts out just as my husband came into the room and grabbed a garbage can to catch it. It was pure bile and stomach contents; I have to imagine that should have been aspirated out of my stomach before I left the OR. No one came into the room to check on me for HOURS. Didn't like that surgeon at all, but he was assigned to me on a somewhat emergency basis; he seemed very flippant and show-offy. The best surgeon I ever had was for an iliectomy for Crohns disease and I could tell his staff worshipped him, for good reason. Best care ever. Still recovering from last week's laminectomy for degenerative disc disease and sciatica (cauda equina) which I let go too long hoping the symptoms would go away or at least not get worse. I was asleep two minutes after they put the midazolam in the IV, never even saw the OR but I still wonder if I was awake enough to transfer myself, or fully out by then. As I've gotten older, the anesthesia seems to work better/stronger on me; I am now 70 and want to thank all the people who have participated in my care all these years. I would have been dead long ago, otherwise. Thank you all for your dedication, this is not an easy career path by any means. Post Covid, it's more important than ever for people to consider these careers.
I have been under general several times. I know I woke up once I remember trying to open my eyes but they were taped shut. I remember someone saying she is waking up! Right after that I dont remember anything.
I was one of those people who commented on having some limited awareness under anesthesia. This VERY rare phenomenon is documented in my particular case but it is EXTREMELY rare. I also wish to add that this experience lasted only for a couple of minutes and I was neither afraid nor in ANY pain. I was not fully awake at the time either. I have undergone dozens of surgeries of various kinds before and since with no problems, and let the anesthesiologist know that I am a pain patient with a known tolerance for opiods and protocol. I regret if my EXTREMELY rare experience would cause anyone anxiety about surgery. It certainly has not caused me any trauma whatsoever.
I've had several surgeries from major to minor and never had any awareness. I've been told prior to the surgery that I will be asked questions as I'm coming out from the anaesthetic that I'll have to answer before going back onto the ward, and I don't remember any of those either! Great job to my anaesthesiologists.
I had both knees replaced and ortho dr. used an epidural and some loopy med to make me forget. I said those don't work on me in colonoscopies. He had several young male residents the day of the surgery. He was known as the cool dr. I heard hammering and drilling and watched the clock. When ever I appeared to be doing something the anesthesiologist would give me something in my IV. He came in early with those same residents the next morning and I was quoting him, "She won't remember a thing" with residents giggling. I said oh but I do remember everything. You had a hard rock concert in there that was not for me. Let me start, "you played ZZ Topp, followed by ...... My ortho surgeon's mouth flew open.
Wow. That was probably midazolam they gave you. I had that for a tooth extraction and felt surprisingly awake. Although it calmed my anxiety, the doctors were lax about numbing because they assumed I wouldn't remember it... they were wrong.
You are definitely right about people that have experienced this will most likely comment and others that haven't experienced anything unusual don't feel as inclined to comment on such video.
My first surgery was a cochlear implant surgery and in this surgery I woke up and it was quite traumatic. I will not go into detail as I do have PTSD.
After having this knowledge of waking up during surgery, I have always made sure I tell the anaesthetist that I have woken up during surgery and I need them to MAKE SURE that never happens again. Since that surgery I have never had any issues.
I have also had surgeries including a colonoscopy under sedation and been asleep the whole time during them and even have trouble waking up from them which I find very strange!
I had a colonoscopy done a couple years ago, the anaesthesiologist looking after me made it very clear that I may have some awareness during the procedure. I only remember the first few minutes after being given the sedatives then I came to in the recovery room.
Great video Max! Appreciate your attention to detail and your commitment to making factual videos.
I have had 6 back surgeries, 1 neck surgery, 1 hernia surgery, and 2 complicated oral surgeries. The only time I was aware of anything was 1st oral surgery. I became aware at end of procedure when I was being stitched up. Lidocaine had just been administered so there was no pain. The awareness was hazy at best.
Before 2nd oral surgery, I relayed this to the Surgeon. He was a different Surgeon from a different practice. He said it appeared to be a situation where light sedation had been given and was just wearing off before procedure was complete. He said they would be giving moderate sedation. If I woke up before procedure was finished, more sedation would be given. They didn't want to be stitching incisions closed if I my mouth was moving around. It worked as discussed.
Another reason to love your channel. You took the time to clear up some people's confusion and further clarify and expand on the subject. I'm here for the peer reviewed data 🙌 You just made me want to write a whole paper on the subject. You're doing a great job at providing us all with free education.
And for the sake of some data, I'm not here because I've had anything close to an anesthesia awareness experience. I'm here because I love learning about medical topics (and have since I was a kid). To me, the more I know, the more calm I can be in a medical emergency situation.
I laughed when you were discussing how to ask questions because I just blurted out "no leading the witness" but your example was a movie. It's clear we're in different fields 😅
I’ve had general anesthesia multiple times and I’ve yet to wake up or remember anything! My memories are me saying hello to the OR nurse, the anesthesiologist, and my surgeon when he walks in, having the mask put on my face and being told to breathe normally, looking at the clock on the wall, then waking up in recovery hours later but feeling like it was only seconds, sometimes with the anesthesiologist beside me asking about my pain level.
I have severe PTSD.
Normally, I have little trouble controlling it , by using several techniques.
I’m concerned that under spinal or regional anesthesia (for my hip replacement), I won’t be able to control MY anxiety, and MY fearful outbursts- which can be very alarming to bystanders.
What should I say to my anesthesiologist so that he can control my reactions during poor emotional regulation.?
Can you be my anesthesiologist?
I've had general anaesthesia twice and in both cases I have zero recollection of anything happening from moments after I was asked to count from 10.
I only watched the original video 2 days ago and this video 3 months after it was recorded. I need to watch more of your videos.
Since 1990, I have had anesthesia at least 35 times and do not recall anything. In 2019, following major ankle and foot reconstruction, the nurse anesthetist came to see me in Recovery and exclaimed about something I had said. He was called away before he could explain. He mentioned "how kind."
Something else: post-surgery memory issues. About 10 years ago I went under general twice within 24h. Both surgeries were abdo, first one scheduled, the second one urgent. Both times I remember nothing from the actual surgery. Second time I woke up and had memory issues for months and months afterwards. Very scary time in my life. I thought I was never going to regain my shortterm memory, thought I was having early onset dementia (I was in my 30's and e.g. Korsakoff was extremely unlikely). It got better with time but learning and retaining new knowledge takes more effort ever since. I don't know if it has to do with the anesthesia but I hope I never need surgery again.
I have an ex boyfriend who woke up while his appendix was being stitched up, that's the only person I've ever talked to in real life who experienced something like this. I've seen a couple of disturbing UA-cam videos, where people spoke about being fully aware during invasive surgery; from what I can tell it does happen but yes it seems very rare. BTW I've personally been under general anaesthetic 4 times, and I have responded very well each time!!
I woke up during a facelift. Didn’t feel anything, but could see the doctors hovering over me. I also remember thinking if anyone knew whether I was awake or not.
Another great video, Dr. Feinstein, thank you. I've become a critic of good anesthesia, having had so many surgeries in my lifetime. My hallmarks of a great anesthesiologist: 1. How soon they get me not caring about anything upon entering the OR. 2. And this is the most important one, IMO. HOW WELL YOU FEEL ON INITIAL CONSCIOUSNESS during recovery! Waking up in minimal discomfort, with no nausea and minimal foggy brain is awesome.
If I remember being annoyed at how the recovery nurse yelled at me like I was old, senile, and deaf during initial recovery, the anesthesiologist did a great job. ; )
Namaste doctor I doyou watch your videos.
I had a broken tibia and had a surgical procedure for for that nearly 6 hours.
General anaesthesia was administered by spine.
While I was being operated after around three hours I came into my senses completely.
I could completely understand what the team of doctors we're doing the sound of electric drill saw.
The anesthesiologist was completely calm, confident.
She expected me to have awareness.
She asked me if I was having any discomfort I replied my shoulder was numb.
I categorically requested for the Ambrose to be removed she kindly acquisised.
She asked me not to look at the headlight and after sometime I again went into it deep sleep.
For me it was not at all traumatic.
I think there are so many comments for your original video because patients get scared aur in general people get scared.
I think that's the reason.
I had bilateral carpal tunnel release under moderate sedation, Propafal, and Baer blocks on the wrists. I remember suddenly waking up and feeling my arm being pulled during the second, right, release. I said to the anesthesiologist, Yo dude I'm awake. and he looked down and said "Not for long". Next thing I knew I was in recovery. There was no pain or freak out just one moment I was awake and one moment I wasn't. So no harm no foul. Had other surgeries with no issues other than scraped vocal cords after lower back surgery but I'm a big boy and I'm sure it happened while turning me on my stomach. I joked with them about getting the pregnant mommy table instead of the "motorcycle" table.
I have only ever had one procedure under general anesthesia, though I knew about it pretty well (mom has been in the medical field her entire life, and my brother's had several surgeries). So as they're putting me on the operating table, after being given whatever that drug is that makes you pretty happy and loopy, I was fully ready to count down from 10.
Then I woke up, and the first thing I asked the nearest doctor was, "Did I count?"
She said, "No, sweetie, you were sound asleep before we even gave you anything."
I thought I woke up in the middle of having my tonsils removed at the age of 8 for years. Now I think as soon as I received the anesthesia I wasn't completely under. I jumped up and asked, "Are my tonsils gone" the nurse smiled and said not yet sweetie you can go back to sleep.
I found that a lot of patients take "sedation" to mean they are "asleep" and completely unaware. Sedation is not the same as general anesthesia and this needs to be made very clear during pre-surgical consultation. People who come in for a knee replacement under "spinal and sedation" can be surprised to learn they are not getting general anesthesia, for example.
I had a hernia surgery, and wasnt aware, but knew that time passed longer than the stated time that the dr said it should take. NO complications other than a larger than normal hernia.
Max, thank you for your factual and compassionate-understandable- videos. I value you them greatly.
I was awake during a procedure and heard everything the doctors were saying.
A friend had that heart test which is done in operating room to test for artery blockages , he became aware of the doctors hurting him and he wished they would stop . It turns out his heart had stopped and they were shocking him with the paddles. One doctor said let’s try a 7th time and that one restarted his heart and he didn’t remember anything more .
You can't use a defibrillator on a heart that isn't beating. Your friend either had a really vivid dream that he recalls as a false memory, or his heart didn't stop.
Have you ever had personal experience with someone that has had a patient have a reaction like Sherman Sizemore? Where a drug was forgotten or for some reason wasn’t effective and the patient had memory of surgery. While Mr. Sizemore didn’t remember on a conscious level due to benzodiazepines being used as an amnesiac. His subconscious had a full 16 minutes of the horror of being cut open during surgery. He was fully paralyzed, but not asleep. He ended up losing his mind and committing suicide 2 weeks after because his subconscious had no conscious memory to tie the extreme anxiety he was experiencing.
I definitely think communication breakdown is the biggest slice of the pie here. Many people don't know the difference between the different kinds of anesthesia, and apparently don't had them explained too well either.
I think there's yet another possibility though: suggestion. Many people will either be afraid of any awareness during surgery, or their mind will try to fill in the blanks of that period they're amnestic for. There are no dreams of course during general anesthesia, but that drugged-up sleep we have in recovery or after? Yeah, your mind is missing time, you're aware of not being in your normal environment, and some meds used in anesthesia can make you loopy. Not hard to imagine how someone might not be able to discern what happened in recovery versus what actually happened in the OR, or even dreams from reality.
In addition to selection bias, people are also more likely to comment about their negative experiences than when everything goes as expected.
I had it happen once, during a dental extraction for a couple wisdom teeth that were wrapped around the jaw in a weird way and required being put under in an OR to do the surgery properly. wasn't for longer than a minute or so but unfortunately that minute was well into the surgery and was well just just say extremely unpleasant. couldn't move or do anything to alert anybody I was starting to wake up but somebody apparently noticed and the dosage was adjusted to put me back out. Found out later there were apparently some minor issues they discovered with some of the equipment they were using when they looked into what happened afterwards. I didn't make an issue out of it or anything, its just fortunate it happened with a comparatively minor surgery with me than with some car accident victim or whatever with serious injuries who could have risked serious physical or mental harm if they started coming out of it when they were being worked on
I have had 3 surgeries under a general anesthesia,a couple offers and three colonoscopies and don't recall anything after doctor gives me the count backwards signal. Usually by 8, the next thing I know is the surgery is over and I am slowly waking up in the recovery room. Just had a unilateral knee replacement in Aug and recall being moved into the table and knee moved into a device. A nurse announced Dr. X has entered the theater recording started at 10:02 and then boom, it was 12:45 and I was offered some juice in recovery.
Unfortunately I have had about 8 surgeries requiring general anesthesia. I am 70. Never had an awareness of any surgery. However, when I had a prostatectomy, there was a surgical accident whereby a minute tear occurred in my colon, successfully repaired. When I awakened, apparently my bed was next to a device that recorded a surgical professional dictating surgical notes. I heard all about the surgical accident but could not speak or move.
I was put under GA for my laparoscopic cholecystectomy.. I'm also a surgeon .
I dont know what happened. But i didnt expected that this would happen to me
I think i was awake..
When i felt being suffocated and unable to breath and believed i was dead that too happened three times in same operation .
It felt i died three times ... Nobody
Was there to save me.. i was so helpless.. when i woke up..i couldnt breath properly ... I couldnt sleeo for three days.. sleeping made me feel as if i was being buried alive. I choked . I couldnt breath.. nobody believed me what i said..
Then i researched and found about anaesthesia awareness.
Now. I'm working on myself.. trying to forget this as a nightmare.
I still have panic attacks...sometimes couldnt sleep... But i'm working on it . .trying to keeo myself calm.... May be its easier for me to cope with this PTSD as im a doctor too..
But sometimes .... It doesnt work... Im scared.. im just scared of ceasing to exist...and nobody believes me that this has happened to me ...
Thanks to max .. atleast he believes..
This is so sad to hear. From everything I've read, when this happens, the patient almost always develops PTSD, understandably. I hope that you find the support you need to put this behind you. I also think the medical community has to be more aware of this when they see it happening to a colleague.
I had the opposite happen. When I had top surgery, I woke up thinking I dreamt the surgery. I felt like going into the OR itself was a dream. The only way I knew it happened was that I had ace bandages on my chest and I felt that my chest was totally flat!
I’ve had a few surgeries and 3 colonoscopies, the only things that came close to awareness were when I had my gallbladder removed they gave me a paralytic before they sedated me ( not sure if a mistake or if that is common?) and remember realizing I couldn’t breathe and not being able to move or tell anyone I was still awake and couldn’t breathe, while scary in the moment I believe it was just a few seconds because that’s the last thing I remember before waking up and the surgery was over and I had no awareness during the actual surgery until in the recovery room
Mine is more so wanting to be less aware going into the OR BEFORE surgery - I had 3 surgeries in two weeks after an accident. The second sx they gave me 5mg of versed pre-op...and i remember rolling into the or and then trying to decide how to move me over and i pipe up "hey i can slide myself over with my good left arm and leg". Then remember then beginning general induction. Being a RN myself my next 3 surgeries i always requested more versed because I didn't like remembering the ride into the or or induction. Lol. But, fortunately all get general anesthesia so definitely wasn't awake until I was in pacu. With my wisdom teeth removal they gave me versed and Propofol and just remember asking what he was giving me and then waking up and already in another room. Thank goodness!!
I am scheduled for knee replacement surgery March 7th. My surgeon employs the spinal block and a milder form of general anesthesia or so I understood him to say. Last time I had a spinal block, afterwards I couldn’t pee when they told me I should so they inserted a catheter. I am dreading the catheter more than I am the surgery.
Can you talk to us about spinal blocks, bladder paralysis, and the need for a catheter?
Thanks.
I have had two operations under general anesthesia, a gastrectomy and had my gallbladder removed and
surgical hernia repaired using the same incision. I do not remember either surgery, I do remember waking up briefly in recovery and the ICU/step down unit.
I’ve had other more minor surgeries done had have some recall at the time I was woken up
Only once; I became aware during an endoscopy. I tried to scream, it was so painful; they quickly said not to move or scream and turned the anesthesia further, and I remember nothing until coming to, later. It was frightening, and hopeful it never happen again!
The time that I was going under anesthesia and I was given the paralysis drug first and the meds to get me to sleep was the scariest 3-5 minutes of my life as I have this surgery every three months. I do remember some things at the end of surgery, but it was all positive and they were always telling me it’s ok I am ok etc.
Okay, so I actually had two dental procedures where I only got sedated and I don't recall a single bit of both of them. I was very happy, because I was quiet scared of the treatment I got. I had to pay for that myself though (I'm from Germany) and the bill was around 120€. The medication they used was actually written on the bill and there was Ketamine, Propofol, Fentanyl and Midazolam.
All of those are capable of causing prograde amnesia (loss of ability to form new memories) in sufficiently high doses, when used in combination this becomes a significantly more likely result. So it would make sense that some patients would completely lose the ability to form any long term memories under such sedation and thus be unable to recall any part of the experience. Even those patients that were to remember something it would likely be a fragment here or there, not a clear coherent memory of the entire experience.
Thank you! Definite difference between general anesthesia and sedation. I have never remembered anything while under general anesthesia. I won't allow for sedation because I would like to live. I have to be totally out. I refuse to have oral surgeons give me sedation. I am ok with local anesthesia in my mouth but not elsewhere.
0.1 percent is obviously small, but when there’s millions of surgeries with people under general anesthesia, that’s still tens or even hundreds of thousands surgeries with awareness
Thanks for this video.
I have had several surgeries and have never awakened during the procedures
I had conscious sedation for dental work, and though I don’t remember much, it ultimately didn’t work on me because I was awake enough for my gag reflex to get in the way of it all. I do remember hearing someone say ‘I can’t keep the bite block in her mouth’, and that’s it. I don’t remember feeling any certain way, physically or mentally.
Then it was determined that general anesthesia was the best option for me. I remember an anesthesiologist putting the IV in. She was asking me if I had any pets, and I was answering her. I suddenly felt a bit light headed and saying I needed to close my eyes. The next thing I remember was hearing someone calling my name and saying that the work was done and it all went well, then asking how I felt. It literally felt like I closed my eyes, dozed off, and then woke up again. No pain, no memory, a very pleasant experience considering what was going on!
There’s a lot of misinformation about the differences in types of sedation, and I think your videos do a wonderful job at clarifying and putting minds at ease!
It is common for patients who have Ehlers Danlos Syndrome to become aware during general anesthesia.
Been having a few knee surgeries lately and my anaesthesiologist have been doing a great job. Big respect to all of you!!! Love y'all
In the UK, gastroscopy and colonoscopy are now commonly undertaken without even sedation.
As a 9-year-old in 1971, I experienced awareness under general anaesthesia for dental extraction. I was induced with Brietal (Methohexitone) and thereafter maintained on oxygen and nitrous oxide, no volatile, and intermittent boluses of more Methohexitone. Back then, there were no vital signs monitoring devices in dental practices - just observation of PPP (pulse, pallor, pupil). Pulse oximeters had yet to be invented.
A funny thing that happened when I had oral surgery for wisdom tooth extraction many years ago. After the surgery, the oral surgeon asked if I remembered anything. I remembered some sensation of pressure-- no pain, no awareness of what was happening--just some feeling of pressure. The surgeon said that I got the hiccups during the surgery and they had to bring me up just a bit to control the hiccups.
I would not even call this being aware under anesthesia or sedation, I was feeling no pain or anxiety. I was not even conscious enough to think about it, just a feeling of pressure.
Well as a counter to selection bias when I had a procedure under a general anaesthetic last week I didn't even get a far as remembering them actually administering any medication. I remember being wheeled into the pre-op anaesthesia room, I remember them putting the canula in and telling me they were about to administer the medication, then I was in the recovery room. I do not even remember them connecting the medication to the canula let alone administering it. But then I guess that blocking the ability to form new memories probably causes a little retrograde amnesia during induction as the short term memories from the last few minutes wont have been committed to long term memory yet and thus never will as the medication inhibits that process.
I had general this past September for a foreign object removal via upper endoscopy (accidentally swallowed something during an orthodontic procedure- BTW, ask your GI doctor what the most unusual things are that she/he has pulled out of peoples stomachs- I guarentee they have a list). I remember only one thing, and it probably happened while I was waking up- I could have sworn that I dreamed while under. Like I said, it was probably while waking up but before forming new memories (or while that was starting up) or I took a little nap between the anesthesia being discontinued and my fully waking in the recovery area. I remember thinking,” Wow! You dream while under general anesthesia! Cool!” Probably not, but it certainly was interesting.
I remember being aware of being extubated after one of my surgeries. Later that day, I had no memory of the procedure but definitely remembered being aware-rather than having the memory of the experience, I remember being aware of the experience. I suspect even if I were to experience anesthesia awareness, I would have no recollection of the event unless anesthesia was already stopped and my brain was already on the edge of being able to form new memories.
I’m a recovery nurse and knowing the patient is extubated in the operating room they wake up groggy and see bright lights, lots of staff including the surgeon and maybe feel pain, they often drift back to sleep on transfer to the recovery room and when they wake fully in a different area recall the waking experience and think they woke up during their surgery. Luckily the majority of my patients don’t recall waking during extubation!
i remember waking up during extubation and gagging, while someone was saying my name, and that they were all done with my surgery. i mustve fallen back asleep, because i dont remember being wheeled to recovery.
I had 4 surgeries on my right knee. They were general anesthesia. The 5th was also general, I made it into the operating room while still awake, strapped down as if being crucified, then after a bit fell asleep. The 6th time having total knee replacement I told the anesthesia guy, and remember leaving preop
Hello Dr. Feinstein. I haven't, to my knowledge, had a period of awareness from general anesthesia, and I've been under general a few times. I have had one period of awareness while under deep twilight sedation for a cardiac catheter procedure. I was aware of, but not remembering the conversations that the staff was having. I did start to come up out of it before they were done, as I remember feeling this grating abrading feeling in my left arm when they moved the catheter. I don't know if I actually said the words "I felt that", or just mumbled something incomprehensible, but I do distinctly remember the doctor saying "He's still awake!" in kind of an "Oh ####" tone of voice, and then the next thing I remembered was being wheeled out of the cath lab to recovery area.
18 years ago I had a colonoscopy done , I woke up 3 times it was then I heard DR say I won’t go any further
I woke up from GA crying my eyes out but not knowing why. I don't know what to make of it. Maybe I did have some awareness during surgery, but I forgot it all like how a dream often disappears from memory when you wake up.
A friend of mine bursts into tears every time she wakes up from any amount of anaesthesia, she's never remembered any of her procedures it's just a physical reaction her body has to the medication
@@biosparkles9442 That's testable. Just put her under GA without anything else done.
I am a dentist that offers moderate anesthesia care and very much enjoy your videos. In this episode you commented that viewers of a previous episode referenced "waking up" while having wisdom teeth removed. The reason (problem) is nomenclature. About 15-18 years ago, the American Dental Association (like most professional organizations) adopted the ASA's nomenclature for anesthesia. There are four states: two conscious (minimal and moderate) and two unconscious (deep sedation and GA). That is the nomenclature we are "supposed" to be using. However, unlike medicine where physicians are responsive to their professional organization (specialty board), dentists are responsible directly to the state (ie state dental board). Unfortunately, as a very small cog in a state's bureaucracy, state dental boards are very slow to respond to change. While state dental boards may offer a variety of permits for different techniques for minimal and moderate sedation, they typically "lump" any unconscious state of anesthesia (deep sedation and GA) together into a permit called "General Anesthesia." This permit is only open to dentists that have completed an oral and maxillofacial surgery residency (5 years) or a dental anesthesia residency (3 years). From a patient safety standpoint, this works fine; it isolates rendering a patient unconscious to only be treated by providers with years of formal post-dental school experience. Unfortunately, it is technically a misuse of the phrase, "General Anesthesia." I do not know of any oral surgeon that is truly providing GA for wisdom teeth removal; they are actually providing "deep sedation." Even those that choose to intubate a patient are still using local anesthetics, so the patient is really "deeply sedated," not under GA. HOWEVER, everyone in dentistry refers to what oral surgeons do as "GA" because that is what the license is called. Yes, we're part of the problem but I don't see it changing soon.
Had anesthesia for dental surgery and couldn't feel a thing but was aware of what was happening. However, the reaction to the anesthesia was troubling. I cried and cried and cried. No pain but is sure did get the staff very worried. The cry jags lasted for a few weeks at odd times but still there was no pain or reason so cry.
I think coming out of anasthesia is what people are getting confused about. I remember someone saying "one polyp removed right" but don't remember being moved to recovery. Came out really fast though. Going to sleep was very odd though lol.
It was 40 years ago during a “crash” induction for a c-section for hypertension. I understand my BP was very labile. I don’t remember being intubated but do have some recall of significant pain without being able to move, shortly thereafter. I’ve heard this story from others but, again, 40 years ago….
Hey, Doctor Max, another great vid! I've had an unfortunate number of procedures in the past 10 years. Due to previous issues with sedation, I always, always demand general anesthesia regardless of the "routine" or "typical" practice. Anesthesiologists are always understanding, given my history with sedation. I had only a single instance where they stated they could not give a general for angioplasty and stenting of the common iliac artery. With that one, the sedation once again failed and I have total recall of the entire 2 1/2 hours on the table. I had one procedure where the proceduralist got in a hurry and began the procedure before the CRNA had me fully induced. That was a horrible experience. In ll other general anesthesia procedures - including colonoscopies - I have zero recall. I will never again have an angioplasty, or any other significant procedure if they can't use general anesthesia, given my terrible experiences with sedation.
I had left a comment about waking up during a procedure on the previous video. I should clarify that it was an endoscopy followed by colonoscopy looking for bleeding and I had asked that they bring me up in sedation level during the colonoscopy so I would be more alert during the post op review with the doctor. I was not at all upset that I was alert when they found and marked the tumor, and not unacceptably uncomfortable. The surgeon who came in to consult with the Doctor performing the colonoscopy was the one that was later freaked out that I was alert and remembered. He had a colonoscopy coming up himself want really wanted to make sure he wouldnt remember any of it. I thought my anesthesiologist did a great job threading the needle and keeping me comfortable, but fully alert by the end of the procedure so I could digest the news.
@K Mine was when they located the tumor on my far right side, so midway through the procedure. The die injection into the tumor was a little uncomfortable, but ok. That scope tube feels like a garden hose though!
@K I was just glad they found out why I was bleeding internally. On the funny side, they did the endoscopy first so they gave me something to relax me that was awesome. Then the nurses stuck this bit in my mouth so I couldnt bite the tube I guess. I was like, hey didnt I see this in pulp fiction, there isnt a gimp coming in, is there. They started laughing and the anesthesiologist said, yep thats enough, hit a plunger and I was out. 🤣
@K I just had my 3rd, and I think it gets easier each time. Just try and relax and talk to you nurse and anesthesiologist. They really want you to have a positive experience. My last one was just a month ago, my 4 year post cancer surgery check. They were super good about addressing my concerns. My 2nd endoscopy was an emergency gallbladder procedure. That one they just hammered me out and I remember nothing but seeing the Doctor and apologizing for ruining his evening. Then nothing. Ill keep you in my thought and again, if they know you are worried they usually treat you extra gently.
In some countries it's not uncommon for wisdom teeth removal to be done by a maxillofacial surgeon under general anaesthesia. I had my wisdom teeth removed under general anaesthesia in a hospital (Australia) because it was a complex case due to one of the teeth being impacted and very close to my facial nerve, I didn't have any awareness during it though.
Including the wisdom teeth surgery, I've had 3 surgeries under general anaesthesia and had 0 awareness or recall from any of them. All 3 I remember pretty much the same way: I start counting down from 10 and get to like, 7 or 6, and then wake up in recovery violently shivering. I dunno why I always feel *so* cold after anaesthesia, but the blankets from the blanket warmer are the best thing ever and make up for it.
I've also had one procedure done under what they called "twilight sedation", which I'm pretty sure was just propofol. I was warned I might have some awareness and may remember some things, but thankfully I also don't remember anything from that procedure, though apparently I was conscious enough to attempt to talk to the doctor and nurses lol
Must be nice because that’s definitely not how it is in France! 😂 I just got a shot in the gums and then the twisting and pulling began! And yes, it hurt a whole lot still!
@@werewolflover8636 It's still not the norm here, but it's more common than it seems to be in other countries
Wait some people forget everything when under sedation, I've never forgot anything under sedation, I thought it was just to numb the pain a little.
Saying that I've been conscious and fought against surgeons (leaving lots of nicks and cuts where they shouldn't be) under general anaesthesia but have no memory of it.
Local anaesthesia also doesn't work on me (it has a mild effect but no more than slapping the skin does), when a nurse was stitching my head after a fall she pumped all the local anaesthesia in she could and I said I still feel it, she said that's not possible and she had used as much as she could, I told her to carry on regardless as I needed the stitched, I then proceeded to close my eyes and talked her through every stitch in and out, when I opened my eyes all the colour had drained out of her face and she looked visibly shocked.
I woke during spinal fusion surgery. I was face down on the table couldn't open my eyes and heard heart monitor going off followed by oh shit
I have false memories from a time under, what I believe was general anesthesia. I was about 5 years old and having laser eye surgery on my retina. Adults can do this surgery fully awake with no sedation, which I later did, and it isn't very painful. However, children cannot be expected to sit still with a powerful laser being shot into their eye. I remember them putting the gas mask on and me not liking the smell of the gas. Then I remember us somehow deciding not to do the surgery and going back to the waiting room to wait for the time that the surgery would have taken. I then remember waking up in the recovery room.
Obviously, the surgery had actually happened. Perhaps some of the people commenting also have false memories that are simply much more accurate to what actually happened. As a child, I didn't know what would happen, but as an adult, I will generally know a bit about what will happen before a surgery and have the knowledge necessary to fabricate a decently accurate false memory.
I was terrified this would happen to me when I had surgery, and instead I woke up after the surgery in insane pain, but they wouldn't do anything to help me and kept telling me it was all in my head or something. They thought they were controlling my pain with benzodiazapines that didn't work on me because I used to take them for over a decade and was in active benzo withdrawal syndrome at the time. I tried to climb off the table so they gave me something to put me under pretty quick after that.
Wait, so if GA is the only form of sedation you would expect no awareness with recall from, does that mean it's not unexpected from spinal and sedation? Because it's really common to use that for hip and knee replacements here and I cannot imagine how traumatic it would be to wake up whilst having my hip removed!
Correct- I would not be surprised if someone became aware during spinal with sedation. Not saying it’s the norm, but it wouldn’t surprise me.
Remember being aware during the surgery done not mean being in pain. I was a circulating nurse in the OR. The level of sedation is unique to each patient. Some are fairly awake and may talk some others are mostly napping when using sedation and regional anesthesia and this is explained to them before surgery so it's not a surprise.
the operation I had, and I woke up in the middle of the operation were back in the early 80's. Gee, that is like 40 years ago? I take it that the craft has gotten better over the years.
Your datas are likely just as correct as you think they are.
at least, as far as I know.
During a heart ablation, which was not general anesthesia but through an IV, a kink got in the IV and I woke up. Nothing hurt, I was just irritated at the time because my face was covered and I was hot, plus my arms were tied down. They put me right back under. Later I asked if this happened and the anesthesiologist said it had. By that time I wasn't upset because all went well...plus it makes a great life story.😁 No harm done.
I recently had shoulder surgery. After getting wheeled into the O.R., the anesthesiologist told me he was going to give me my first med. I remember acknowledging. The next thing I knew, I was waking up and the surgeon was telling me how everything went and what he found. Oddly, some of the things he told me he was going to do first - having me breathe pure oxygen, etc - I have no recall of. Maybe I'm just a light weight and the first meds made me fall asleep faster than expected.
Same - I feel like a lightweight because I don't remember anything after I was started on midazolam. It was 4 minutes later that my chart shows they started the next round of drugs but I was 100% out a few seconds after after I heard "I starting you on the first drug that should ease your mind a bit" - next thing I knew, I was waking up in the PACU lol
To me its crazy how people get sedated for wisdom tooth extractions in the US. Here in Finland thats very rare, you get injected with analgesic in the gum (which works very well) and no sedation. Only if its required because of excess inflammation, or nerves or whatever. I had a wisdom tooth extracted with just pain killer, I didnt feel a thing but was perfectly awake and aware. The extraction itself took like 10 seconds at most, then a few minutes of stitching up and all done.