IT’S a terrifying scenario, that crosses the mind of many patients going in for surgery.
What if the anaesthetic that’s supposed to knock you out doesn’t work?
Facebook Donna Penner thought she was going to die on the operating table when she woke up just as the surgeon made the first cut into her stomach
BBC Donna said she couldn’t move, scream out, open her eyes or cry to try and alert medics to her ordeal
That fear became a disturbing reality for Donna Penner, from Altona in Manitoba, Canada, just before her 45th birthday.
The mum had been suffering severe bleeding and pain during her period, and doctors had referred her for a exploratory op in 2008 to investigate.
It should have been a routine procedure, but for reasons that are not clear, Donna’s anaesthetic failed and she woke up just as the surgeon went to start the operation.
‘I heard… scalpel please – and froze’
“I could hear the staff banging and clanging and the machines going – the monitors,” she said.
Her first thought was that her surgery was over.
But it hadn’t even begun.
“I was feeling a little medicated, but at the same time I was also alert and enjoying that lazy feeling of waking up and feeling completely relaxed.
“That changed a few seconds later when I heard the surgeon speak.
“I heard him say, ‘Scalpel please’. I just froze.”
‘I felt the cold blade as it pierced my skin’
The next moment the now 55-year-old felt the cold blade of the surgeon’s knife against her tummy as he pressed down to make his first cut into her abdomen.
Overcome with excruciating pain, she tried to sit up and shout out.
But, her body was paralysed by a neuromusclar blocker she had been given.
“I felt so powerless,” she told Mosaic. “There was just nothing I could do.
“I couldn’t move, couldn’t scream, couldn’t open my eyes.
“I tried to cry just to get tears rolling down my cheeks, thinking that they would notice that something was going on.
“But I couldn’t even make tears.
“It felt like someone was sitting on me and holding me down, and there was absolutely nothing I could do.”
‘I wiggled my foot but no one noticed’
Eventually, Donna managed to focus all her attention to move one foot – wiggling it very slightly.
She said she was overcome with relief when one of the nurses placed his hand over it.
Before she could move it again, however, the nurse let go.
She tried three times but failed to catch anyone’s attention.
‘I thought… this is it, this is how I’m going to die’
Donna’s agony should have ended when the surgeon finished her op.
But, as the neuromuscular blockers began to wear off, Donna started to move her tongue around the tube stuck in her throat.
She was trying to alert staff to the fact she was awake, but staff misread her signals and began to withdraw the breathing tube too soon.
Removing the tube before the paralysis drug had worn off could have suffocated her, leaving her lungs unable to function.
“I was lying on the table and he took away my life support, my oxygen, I couldn’t take a breath,” she said.
Donna accepted she was going to die.
She added: “I thought, ‘this is it, this is how I’m going to die, right here on the table and my family will never know what my last few hours were like because no one’s even watching what’s going on.”
She said the operating room began to slip away, feeling more distant as she endured an out-of-body experience, the committed Christian convinced God was with her.
It was only after medics restored her breathing tube, that Donna drifted back into consciousness and woke up, crying on the operating table.
Donna isn’t alone
Understandably, Donna’s ordeal has scarred her.
She regularly suffers panic attacks and struggles to wear any clothes that are tight around her neck.
Donna isn’t alone. There is evidence that around five per cent of people wake up on the operating table – and possibly many more are affected.
Thanks to the amnesiac effects of the drugs, however, most of these people won’t be able to remember any of their ordeal.
Peter Odor, a registrar at St George’s Hospital in London, said: “Almost three million general anaesthetics happen each year in the UK alone.
“As a consequence, it is more probable than not that someone, somewhere in the world, right now is aware during their surgery.”
Why does this happen?
As with any medical procedures, anaesthetic can come with complications.
Some people may have a naturally higher threshold for the drugs, meaning they don’t reduce the brain’s activity enough to dim a person’s consciousness.
In other cases, where injuries involve heavy bleeding, an anaesthetist may be forced to use a lower dose of anaesthetic for the patient’s own safety.
And it can also be difficult to time the effects of the different drugs, to ensure the dose – which gets you to sleep – doesn’t fade before the maintenance dose – to keep you unconscious – kicks in.
In many cases, patients can alert doctors if the drugs haven’t worked.
But where they have been given neuromuscular blockers, that isn’t possible as they cause paralysis.
The good news, for most of us, is Donna’s terrifying ordeal is rare.
One of the largest investigations carried out in Britain and Ireland in 2014 found the overall prevalence was just one in 19,000 patients wake up like this.
The figure was higher – around one in 8,000 – where paralysis drugs were also used, which is expected as it prevents patients from alerting medics.
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It means patients are still more likely to die during surgery than wake up in the middle of it, confirming doctors’ suspicions that it’s a very remote risk.
Dr Odor added: “Anaesthetic drugs disrupt your ability to encode a memory.
“And the dose that you give to obliterate memories is lower than that you need to obliterate consciousness.
“So memory goes well before consciousness goes.”
That means while more people probably experience Donna’s ordeal, they simply can’t remember it afterwards.
Getty – Contributor Doctors warn many more people may endure what Donna went through, but thankfully don’t remember it
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