Somatic Psychology

Bridging the mind-body gap

Medical Trauma: When A Procedure Goes Wrong

Waking up during surgery is a nightmare come true.

A little-known type of Post Traumatic Stress Disorder (PTSD) arises as an aftereffect of a traumatic surgery or medical procedure. 

Imagine waking up from anesthesia during a surgical procedure, becoming fully aware of what is happening, perhaps being able to feel the sensations of surgical tools cutting into your body or pulling at your organs, yet not being lucid enough to react, speak, move, or otherwise alert anyone to your experience. This sounds like a horror story, doesn't it?

For the roughly hundred people who wake up each day during surgery, this has been a nightmare come true. A 2003 article in USA Today1 divulged that a study conducted that year exposed this high number of surgical "wake-ups." "Anesthesia failure that allows a patient to wake up during surgery, paralyzed and unable to cry for help" is an understandably terrifying and traumatizing risk of even minor surgery. It can indeed lead to Post Traumatic Stress Disorder (PTSD).

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Aside from anesthesia mishaps, trauma can occasionally result from a wide variety of other medical incidents including surgery (in general), high fevers, dental procedures, and prolonged immobilization as a result of injury.

Additionally, intense medical situations can further exacerbate an existing condition or trigger an acute episode. According to Primary Psychiatry, "Anxiety disorders, depression, bipolar disorder, schizophrenia, and personality disorders may all flare up during the post-operative period, leading to psychiatric consultation."

Primary Psychiatry also says that: "Posttraumatic stress disorder (PTSD) is also common after surgery, particularly after traumatic injuries, but is under-recognized and undertreated. Previous research has evaluated these and other issues in surgical patients." As you might expect, Medical PTSD is most common in patients who underwent emergency surgery as a result of a traumatic event such as a car accident, a fire, or an assault. Therefore, it can be difficult to ascertain whether the PTSD came about as a result of the original traumatic incident, the medical procedure, or both.

Now for the good news, at least on the anesthesia front: in recent years the Food and Drug Administration has approved and begun to advocate the use of a device called a BIS monitor, which translates a patient's brainwaves into an indicator of how sedated they are at any moment during surgery. This device can be used to indicate when a patient is truly sedated and unable to consciously experience the procedure.

Citations:
1. http://www.usatoday.com/news/health/2003-10-12-surgery-usat_x.htm
2. http://www.primarypsychiatry.com/aspx/articledetail.aspx?articleid=1067

 

Susanne Babbel, Ph.D., M.F.T., is a psychologist specializing in trauma and depression.

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