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Experts Agree That One Case Is Too Many; Tackle Tough Issue of Anesthesia Awareness
Date:11/30/2007

- Stryker Instruments Launches OR-Live Information Resource Portal to

Advance Public Understanding of Rare but Traumatic Event -

NEW YORK, Nov. 30 /PRNewswire/ -- A dynamic panel of researchers, anesthesia professionals and a patient/advocate assembled this week at a forum for healthcare journalists to tackle the complex issue of anesthesia awareness, the rare but devastating condition that is of heightened public concern due to today's release of the movie "AWAKE." The forum, "A Wake-Up Call About Anesthesia Awareness: Striking a Balance in Public Perceptions," was convened to address the range of related challenges, controversies and concerns in order to forge a positive path ahead to reduce anesthesia awareness and improve patient safety.

"While AWAKE may send shockwaves through the systems of those about to have surgery, and those who have suffered this rare event, it also serves as a wake-up call to health professionals to do all we possibly can to reduce the occurrence of anesthesia awareness," said Orin F. Guidry, MD, Professor, Anesthesia and Perioperative Medicine, Medical University of South Carolina.

ONE CASE IS TOO MANY

Anesthesia awareness occurs when a patient under general anesthesia stays or becomes conscious during surgery but can't move or talk because paralytics are in effect. While the incidence of anesthesia awareness is rare, it can have devastating effects. The incidence, based on several studies, is reported to be 0.1%, which translates to about 21,000 of the 21 million people in the United States who receive anesthesia each year. [1]

Dr. Guidry emphasized that that dispute over the number of cases should not distract from the shared sense of urgency to address the issue. "Let's get out of this box of how often it occurs. Really, one case is too many," he said. "As anesthesiologists, we are not going to stop until we can get that risk down to zero."

PATIENTS, ADVOCACY AND IMPATIENCE

Carol Weihrer, President and Founder of the Anesthesia Awareness Campaign, Inc., provided her unique perspective as a patient/advocate whose experience with awareness propelled her effective advocacy for patient safety and support. Describing her work on behalf of those, like herself, who have experienced this life-altering event, Ms. Weihrer said, "I am a patient, I experienced awareness; I am passionate; and I am impatient! It's my life's work to direct my passion toward those who have had their lives changed by this terrible experience."

Carol suggested that patients become more proactive both in preparation for and in follow up after their surgery. "I encourage people to empower themselves with research and education about their surgery, including the anesthesia. They should have a very frank discussion with their anesthesia professional in advance," continued Carol. "Always ask about monitoring, ask about paralytics, and be very forthcoming about any drugs that you are taking."

LEVEL OF CONSCIOUSNESS MONITORS

The use of brain function monitors during surgery can reduce the likelihood of an individual experiencing anesthesia awareness, according to the panelists, who emphasized that these monitors are an important strategy, not a solution. "These monitors provide additional information that nothing else in anesthesia monitoring does. I would like to see consciousness monitors in every operating room and available for every surgery at the discretion of the patient and the anesthesiologist," said Daniel J. Cole, MD, Professor and Chair of Anesthesiology, College of Medicine, Mayo Clinic, member of the American Society of Anesthesiologists Task Force on Intraoperative Awareness.

Dr. Cole pointed to progress: "A 2005 American Society of Anesthesiology survey showed that 64% of anesthesiologists reported not using a brain function monitor. In a 2007 Stryker National Attitudes and Perceptions (SNAP) survey, 22% of those surveyed reported not using monitors. While the surveys used two different methodologies and therefore are not absolutely equivalent, this indicates that we've made significant improvements in addressing awareness. But we're not there yet."

Marc Bloom, MD, PhD, Director of NeuroAnesthesia at the New York University Medical Center sees promise in new technologies. "As more options become available to provide level of consciousness monitoring," Dr. Bloom said, "patients can be reassured that they have an opportunity to have the best possible anesthetic care."

PROMOTING GOOD COMMUNICATIONS

Tom McKibban, CRNA, MS, with Butler County Anesthesia Services, LLC, provided key questions that should be asked of patients recovering from surgery following general anesthesia:
-- What is the last thing you remember before going to sleep?

-- What is the first thing you remember waking up?

-- Do you remember anything between going to sleep and waking up?

-- Did you dream during the procedure? He noted that in the first few weeks after general anesthesia, patients should also be asked what the worst thing was about the operation. "If they say the nightmares or recurring dreams, or other disturbing experiences apart from post surgery pain, we need to follow up with that." That follow-up may include referrals for counseling to help patients cope with what Weihrer calls the "life-changing experience" of anesthesia awareness.

A PATH FORWARD

Dr. Cole explained the next steps to getting us closer to reducing anesthesia awareness to the lowest levels possible: "I see four primary drivers: One is medical science, always the basis for the best patient care. Second is the patient/physician relationship. I believe it's essential for patients to come in engaged and empowered; to ask tough questions and get honest answers. Next is industry, which plays an important role, and will continue to in the future. And finally, patient advocates have a substantial role in bringing this issue forward."

"This gathering represents an important milestone in the four-front fight against anesthesia awareness -- with representatives from each engaged toward a shared goal. As we redouble our efforts - agreeing that one case is too many and that much more must be done - we may hope to one day relegate anesthesia awareness to the stuff of which only thriller movies are made," Dr. Cole concluded.

For more information about the forum, anesthesia awareness and level of consciousness monitoring technology, visit http://www.OR-Live.com/AnesthesiaAwareness.

About Stryker Instruments

Stryker is a worldwide leader in the medical device industry and has marketed innovative solutions for the surgical suite for over 65 years. The Company's dynamic growth has come from its range of premium quality, innovative products and services as well as from the exceptional dedication and focus of its workforce. Stryker's strong heritage in the Orthopedic Implant and Equipment market provides the Company with a unique command of the key needs in the surgical suite, while fueling innovation that expands product offerings in the anesthesiology space.

Stryker is committed to working with the scientific community and applying its high standard of clinical excellence to the anesthesiology space. The SNAP II LOC monitor represents innovation, precision and the most advanced technology to complement standard anesthesia control monitoring.

[1] Sebel, P.S., Bowdle, T.A., et al., "The Incidence of Awareness During Anesthesia: A Multicenter United States Study," Anesth Analg, 2004; 99:833-9


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