Wake-up call for rude doctors

DOCTORS who insult patients on the operating table risk being overheard when the general anaesthetic doesn't work.

Patients have reported hearing themselves described as fat and ugly by surgeons who thought they were unconscious, when in fact they were just unable to move.

Around one in 500 patients regain some level of consciousness during an operation.

And a study of awareness while under a general anaesthetic by experts in Germany found 45 patients who had had experienced it during a range of operations from heart and emergency surgery to ear, nose, throat, gynaecological and dental procedures.

The problem seems to occur when too little anaesthetic has been given, or the cocktail of drugs and gases which make up the anaesthetic isn't quite right for the individual.

Awareness during general anaesthetic is commonest during procedures where doctors try to give minimal amounts, such as caesarean operations to cut the risk to the baby, and in heart surgery when it may not reach the brain.

The use of muscle-relaxant drugs makes the patients unable to let anyone know that they are still conscious.

In the German study some patients reported being aware of what was going on for up to an hour during surgery.

Half said they were struck by the personal nature of remarks about their bodies, the disease or the operation and were able to see what was going on.

All of them found themselves immobile and were unable to alert someone.

Eighteen said they were in a state of severe panic.

Professor Dick Schwender, of Germany's Institute for Anaesthesiology, who interviewed the patients, said: "The feeling that they were unable to influence the situation was more important than the pain some of them said they suffered."

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