IT’S something that terrifies anyone facing the prospect of an operation, that fleeting thought; ‘What IF I wake up?’.
For Barbara Tite that nightmare become her spine-chilling reality, after she went under the knife to fix a and felt hands “rummaging around” in her abdomen.
Barbara Tite experienced a lot of people’s worst nightmare – waking up from anaesthetic while being operated on Credit: Supplied
She says she was unable to move or speak and felt terrified – until she was able to give a signal to the team looking after her Credit: Supplied
Unable to scream or move, the former special needs teacher from was confused and became increasingly terrified.
“I couldn’t do anything. It was utterly horrendous, like being buried alive,” she remembers.
“At first I thought I’d come round and was in recovery. There was no pain but I felt the sensation of the hands tugging inside me.
“I could hear muffled laughter. It was then that I realised in sheer horror I was still being operated on but they didn’t know I had woken up.”
Barbara tried blinking, but her eyelids wouldn’t cooperate.
“I wanted to scream but couldn’t move my head or open my mouth.”
Somehow, Barbara summoned every bit of strength she had to alert the surgical team of her predicament and managed to wiggle her little finger.
She felt someone touch it before she slid back into anaesthetic oblivion.
Barbara experienced a very rare phenomenon called “anaesthetic awareness”, which only happens in around one in 19,000 general anaesthetic instances Credit: Supplied
It was 2024 when doctors discovered a potentially life-threatening perforation in Barbara’s bowel and she was rushed into theatre for the five-hour emergency operation Credit: Supplied
“When I woke, I was in recovery,” says Barbara, and this time, she really was.
She has no idea how long she was awake during her .
“It felt like ages, but could have been seconds. All I knew is I was aware,” says Barbara, whose husband Brian, 72, with whom she shares two sons – 39 and 42 – is her registered carer.
Regaining partial or full consciousness during surgery while under general anaesthesia is called “anaesthetic awareness”, and is a common fear, even though actual cases are very rare – it only occurs in one in 19,000 general anaesthetics according to a 2014 report from the Royal College of Anaesthetists
A 2016 study published in the Saudi Journal of Anaesthesia found that despite how unlikely it is, almost three-quarters (74 per cent) of surgical patients worry they might wake up on the operating table.
Those unlucky enough to be affected can hear voices, feel pressure where surgeons are operating, experience paralysis and in rare cases, feel everything the surgeons are doing.
Most cases happen when an inadequate dose of anaesthetic is administered as a result of clinical error.
Dr Tim Meek, president elect of the Association of Anaesthetists, says: “The doses of anaesthetic drugs required to send somebody to sleep and to keep them asleep is influenced by many things, including age and weight.”
For instance, younger people tend to have a higher metabolic rate, while being can increase the risk of complications when under anaesthesia, so in both cases, dosage has to be monitored closely.
“The dose may also have to be modified to take account of things like frailty, trauma or critical illness,” says Dr Meek.
Barbara, who’d had a horrific car accident 24 years ago which left her with multiple burns, broken bones and post-traumatic stress disorder (PTSD), was used to being given general anaesthetic, so never anticipated having a problem.
In 2017, she was diagnosed with a rare, incurable blood and bone cancer and was given a stem cell transplant.
In 2024, doctors discovered a potentially life-threatening perforation in her bowel, which can allow bacteria and faeces to leak into the abdominal cavity, and she was rushed into theatre for the five-hour emergency operation she woke up during.
“I’ve never had any trouble with anaesthetic and always woke up afterwards remembering nothing,” she says.
Barbara decided not to make a formal complaint because she was apologised to by a junior anaesthetist, and she didn’t want to “ruin a young man’s career” Credit: Supplied How does general anaesthetic work?
General anaesthetics interrupt the normal transmission between nerve cells in the brain, explains Dr Tim Meek, president elect of the Association of Anaesthetists.
“In doing so, they prevent consciousness and memories from being formed for the duration that they are working,” he says.
By altering receptors like GABA, the brain’s primary inhibitory chemical messenger, anaesthetics effectively turn down the brain’s volume, halting the electrical cross-talk required for awareness, pain perception, and memory formation.
Administering anaesthesia is far from a one-size-fits-all procedure; it is a delicate, real-time balancing act tailored to a patient’s unique physiology.
It’s based off someone’s weight, height, medical conditions and risk.
Critically ill patients may get a lower dose of anaesthesia to protect against cardiovascular collapse, when the heart can’t pump enough blood around the body.
Patients with chronic alcohol or drug use may need higher doses because their tolerance for sedatives may be higher and can change how they react to anaesthetic.
Meanwhile, with c-sections, dosing is limited to protect the baby from post-birth sedation, meaning it can carry a higher risk of accidental awareness.
This time, everything had seemed normal, with the anaesthetist administering the drugs needed to knock her out through a cannula in her arm.
“He told me to count backwards from 10, as always, and I did so.”
The surgeon set to work on her perforated bowel, repairing a twisted hernia too, and removed a metre and a half of dead bowel.
“Next thing I knew, I was awake,” says Barbara.
When she woke up in recovery, two anaesthetists came to see her and the more junior of the pair apologised.
“He held up his hands and said, ‘I’m so sorry, it was all my fault,’” she recalls.
“It was only after the anaesthetic truly wore off that I felt angry.
“I had no follow-up and no care. Just an apology.”
Not wanting to “ruin a young man’s career”, Barbara decided not to make a formal complaint, “but I was very angry and I’m still traumatised,” she says.
If someone does show signs of waking up during a procedure, anaesthetists are trained to notice and deepen the anaesthetic.
“We also monitor numerous bodily functions, including heart rate, blood pressure, breathing – changes in these could alert the anaesthetist to the possibility that awareness could be imminent,” said Dr Meek.
“Taking these things together, the potential for awareness is most usually avoided before it can even happen.”
Barbara got to go home a few days after her operation, but was afraid to close her eyes to go to sleep.
Barbara could hear the surgeons talking. File picture. Credit: skaman306
Her colorectal consultant said he’d never come across anaesthetic awareness.
“He suggested I’d imagined the whole thing. I was furious and burst into tears and left,” Barbara claims.
She is now undergoing chemotherapy for her myeloma and has received counselling for thanks to the intervention of a Macmillan nurse.
“I don’t want to scare anyone, but people should be aware that anaesthetic awareness is possible,” says Barbara.
“Doctors should also be aware that their patients can and do wake up during surgery, and to admit to it when it happens and give them the help and support they need.”
Eze Chidiebere Paul
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