Can patients hear us when they are very asleep? It is possible that patients can hear and feel what is going on around them, even when apparently unconscious, but they might be too sleepy to respond when we speak to them or hold their hand.
Nursing and other medical staff usually talk to sedated people and tell them what is happening as they may be able to hear even if they can't respond. Some people had only vague memories whilst under sedation. They'd heard voices but couldn't remember the conversations or the people involved.
They do hear you, so speak clearly and lovingly to your loved one. Patients from Critical Care Units frequently report clearly remembering hearing loved one's talking to them during their hospitalization in the Critical Care Unit while on "life support" or ventilators.
With minimal and moderate sedation, you feel comfortable, sleepy and relaxed. You may drift off to sleep at times, but will be easy to wake. With general anaesthesia, you are completely unaware and unconscious during the procedure. Deep sedation is between the two.
If they can hear you, they are unable to speak if they have a breathing tube in their mouth. We know from asking awake patients that they remember things that were said to them when they were sedated. It is better to assume they can hear you & talk to them normally, even if the conversation is only one-way.
Anesthesia won't make you confess your deepest secrets
It's normal to feel relaxed while receiving anesthesia, but most people don't say anything unusual. Rest assured, even if you do say something you wouldn't normally say while you are under sedation, Dr. Meisinger says, “it's always kept within the operating room.
Survival. There are reports that after initiation of palliative sedation, 38% of people died within 24 hours and 96% of people died within one week. Other studies report a survival time of < 3 weeks in 94% of people after starting palliative sedation.
Increased activation during sedation may be related to impaired and delayed responses to stimuli during sedation. In the alpha frequency bands, we observed decreased cortical activity in the auditory cortex (AC) and the fusiform gyrus, where significant cortical activity alterations were observed during sedation.
Depending on the procedure, the level of sedation may range from minimal (you'll feel drowsy but able to talk) to deep (you probably won't remember the procedure). Moderate or deep sedation may slow your breathing, and in some cases, you may be given oxygen. Analgesia may also contribute to drowsiness.
You will probably believe you were asleep the entire time, with no recollection of pain, scary sounds, smells or other negative experiences. There is no panic associated with conscious sedation. You are entirely unaware of the effect during treatment.
In most cases, a delayed awakening from anesthesia can be attributed to the residual action of one or more anesthetic agents and adjuvants used in the peri-operative period. The list of potentially implicated drugs includes benzodiazepines (BDZs), propofol, opioids, NMBAs, and adjuvants.
Don't believe the myth that a patient sedated with midazolam or propofol can't feel pain. Studies show otherwise: About 50% of ICU patients who were intubated and sedated recall painful events.
Normally a medically induced coma shouldn't last for much longer than a few days and given that ventilation with a breathing tube and the induced coma comes with risks, the time in an induced coma and on a ventilator should be minimized as much as possible.
These patients often have evolving processes that threaten the airway and adequate ventilation. Furthermore, intubation, ventilation, and sedative choices directly affect brain perfusion. Therefore, airway, ventilation, and sedation was chosen as an emergency neurological life support protocol.
Sedatives act by increasing the activity of the brain chemical gamma-aminobutyric acid (GABA). This can slow down brain activity in general. The inhibition of brain activity causes a person to become more relaxed, drowsy, and calm.
It's best to have someone with you for at least the first 24 hours after general anesthesia. You may continue to be sleepy, and your judgment and reflexes may take time to return to normal. If you are taking opioids for pain, you won't be able to drive until you stop taking them.
Sedation and agitation
The patient will commonly be started on a small dose of sedative (such as a benzodiazepine like midazolam or lorazepam). They may also be given an anti-psychotic (such as haloperidol). Medicines are usually given as injections or through a syringe pump (also known as a syringe driver).
Sometimes ventilator is used during surgery to make sure breathing is not disrupted during the procedure. In that case patient is usually on ventilator in sedation mode. Depending upon the total duration of surgery, patient may be on ventilator for one to many hours.
Coma and unconsciousness
If a patient is very unwell they may go to critical care/intensive care. There they may be placed in a medically induced coma while they get better. This is called sedation with medication. Once a patient is more stable the doctors will reduce the medication to try and wake up a patient.
Potential side effects of sedation, although there are fewer than with general anesthesia, include headache, nausea, and drowsiness. These side effects usually go away quickly. Because levels of sedation vary, it's important to be monitored during surgery to make sure you don't experience complications.
Sedation is commonly used in the intensive care unit (ICU) to make patients who require mechanical ventilation more comfortable, and less anxious. But sedation can have serious side effects, including delirium, that can endanger a patient's life.
This means they will not regain consciousness or be able to breathe without support. A person who is brain dead is legally confirmed as dead. They have no chance of recovery because their body is unable to survive without artificial life support.
The drugs used in general anesthesia do not directly affect the heart. Instead, they slow down the body's metabolism, which can reduce the amount of oxygen being delivered to the heart. This can cause the heart rate to slow down, but it is not likely to stop completely.
If your loved one in hospice care becomes nonverbal and unresponsive, it's easy to believe the misconception that they can't hear you. A recent study, however, reveals that hearing is the last sense that remains for dying patients.
Sedation, on the other hand, puts the patient in a "semi-conscious state" rather than a very deep unconscious state, allowing the patient to be comfortable during surgery with minimal side effects. Sedation can be administered in ASCs and physician offices, whereas medically induced comas are only appropriate in ICUs.