ASA president submits comment to Wall Street Journal regarding anesthesia awareness

I read Mr. Jay’s December 29 Review: The Mystery of ‘Anesthesia’ with interest. The majority of patients the 52,000 members of the American Society of Anesthesiologists (ASA) care for each day have concerns about anesthesiology before undergoing surgery or a procedure. And rightly so. Surgery and anesthesia are inherently risky, but more importantly, because of the ongoing efforts of physician anesthesiologists, anesthesia is safer today than ever before. 

The ASA has long been steadfast in its dedication to patient safety. It was the only organization to receive a “call out” by the landmark Institute of Medicine publication “To Err is Human,” in praise of our work on improving patient safety.

Ms. Cole-Adams’s book “Anesthesia: The Gift of Oblivion and the Mystery of Consciousness” and its focus on anesthesia awareness is not unique. This rare phenomenon is obviously frightening to many patients. However, the latest medical literature cites the occurrence indeed as uncommon - only one or two in 1,000 procedures. And while her book, other television shows and movies have focused on awareness, let me reassure every patient who undergoes anesthesia that physician anesthesiologists customize an anesthesia plan specially for each patient, taking into consideration health conditions, previous problems with anesthesia, medications being taken, and other critical factors. The physician anesthesiologist’s ultimate goal is to protect the life of the patient and make the patient as comfortable as possible. There are some procedures, because of either urgency or unstable patient conditions, that warrant using lower doses of drugs which could place patients at a higher risk for awareness.  These may include but are not limited to trauma, cardiac surgery, emergency cesarean delivery or any other conditions where the patient’s condition is just too sensitive to tolerate higher doses of anesthetic drug.  Under such circumstances, the literature suggests a potential increase in the likelihood of awareness, albeit still rare.    

ASA encourages patients who may have concerns about awareness to talk to their physician anesthesiologist.  Our physician anesthesiologists are there for the benefit of their patients and are dedicated to the relief of pain and total care of patients before, during and after surgery. Through research and advancing clinical developments, our members have advanced the medical specialty of anesthesia, and continue to do so today, investigating how anesthesia may affect patients and using developed practice advisories and position statements to minimize risk. As the specialty that led the patient safety movement, we continue research to make the specialty safer and carefully evaluate our patients’ needs to continue to make a difference in their lives and health.

James D. Grant, M.D., M.B.A., FASA
President
American Society of Anesthesiologists