WASHINGTON -- There is a rare but frightening phenomenon in the operating room: some patients have been waking up during surgery.

The problem is called Anesthesia Awareness and there's a new effort in hospitals to try to prevent it.

Carol Weihrer of northern Virginia recalled how her nightmare unfolded six years ago. During surgery to remove her diseased right eye, she woke up.

"I was thinking clearly as I'm talking to you now. I heard the surgeon say to the resident, 'Cut deeper. Pull harder.' I saw them clip the optic nerve. Everything went black," Weihrer said..

Even though she knew what was happening, there was nothing she could do to stop it. She had been given general anesthesia that included a drug that left her temporarily paralyzed and powerless.

"I was screaming at the top of my lungs, but I knew no sound was coming out," Weihrer said.

Anesthesia Awareness happens when a patient isn't given enough anesthesia. It's more likely in some cases, such as traumas, open-heart surgery and emergency cesarean sections. In those cases, it's too dangerous to give patients high doses of anesthesia.

Doctors estimate that 20,000 to 40,000 patients experience awareness each year. That's rare considering about 21 million people are given general anesthesia annually.

However, the group that accredits the nation's hospitals says awareness is "under recognized and under treated." And it wants that to change.

In an alert issued last month, the Joint Commission on Accreditation of Healthcare Organizations called on hospitals to:
educate staff and patients about Anesthesia Awareness.
provide counseling if a patient wakes up during surgery.

"We, as anesthesiologists, the first thing we want to do is prevent awareness," Dr. John Dombrowski said.

Anesthesiologists do that by monitoring the amount of medicine being given to a patient, checking vital signs and, in some cases, using a machine that measures brain activity.

Anesthesiologists are also looking for new ways to keep patients from waking up during surgery.

"We think there are a lot of new technologies out here, and we embrace them. But we want to embrace them cautiously, after we have ferreted out in terms of the scientific method, in terms of proving them correct or incorrect," Dombrowski said.

Carol Weihrer filed a lawsuit after her surgery. She settled the case and started a patient advocacy campaign to educate people about Anesthesia Awareness.

"We don't speak to scare. We speak to spare," Weihrer said.

Experts suggest talking to your doctor and anesthesiologist before your surgery and ask them about your risk. Also, be honest with them about your medical history.
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