Regarding Mike Jay’s review of Kate Cole-Adams’s “Anesthesia: The Gift of Oblivion and the Mystery of Consciousness” (
Books, Dec. 30): Surgery and anesthesia are inherently risky, but anesthesia is safer today than ever before.
Ms. Cole-Adams’s focus on anesthesia awareness isn’t unique. This rare phenomenon is obviously frightening to many patients. However, the latest medical literature cites its occurrence as uncommon—only one or two in 10,000 procedures. And while her book, television shows and movies have focused on awareness, let me reassure every patient who undergoes anesthesia that physician anesthesiologists customize an anesthesia plan 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. Under such circumstances, the literature suggests a potential increase in the likelihood of awareness, albeit still rare.
The ASA encourages patients who may have concerns about awareness to talk to their physician anesthesiologist.
James D. Grant, M.D., M.B.A.
President
American Society of Anesthesiologists
Schaumburg, Ill.
The author’s friend was no doubt “paralyzed” and completely awake during her C-section because that’s the way we do it for more than 95% of our patients. A spinal or epidural is safest for the newborn and mother. It allows immediate mother-child bonding, and breast-feeding if desired, with the spouse present. It also is one of the most common surgical procedures performed in the U.S., over a million every year.
Mark A. Klapperich, CRNA
Greenville, S.C.
