Interesting fact contrary to popular belief: the vast majority of civil war surgeries involved some form of anesthesia. The notion that doctors were going around lopping off limbs of wide awake soldiers is a myth.
Interesting fact contrary to popular belief: the vast majority of civil war surgeries involved some form of anesthesia. The notion that doctors were going around lopping off limbs of wide awake soldiers is a myth.
> the vast majority of civil war surgeries involved some form of anesthesia
I can't find the article at the moment but I recall seeing somewhere that it was pretty common for incorrect amounts of anesthesia to be administered and many patients waking up (or worse, being aware of their surroundings and able to feel pain but being unable to move or scream; a personal nightmare of mine). Even if this was a small minority of cases it's still haunting enough to leave a legend that roughly corresponds to the myth you cite.
It is a thing, but not during the civil war. The horror story happens when using drugs meant to paralyze internal organs. Those drugs don't make you sleep, just paralyze you and your organs so your intestines aren't squirming around as the doc tries to fix something. So if they give you that, but not the actual anesthetic, things go bad. Modern hospitals have devices to pick up on this situation. (In the extreme situation of full consciousness, anyone monitoring heart rate will notice something is very wrong.)
In civil war days this didn't happen as they didn't have the artificial respiration necessary to support such drugs. You could easily have been given not enough, but the paralysis-but-awake thing (true "anesthesia awareness") wouldn't happen.
https://en.wikipedia.org/wiki/Neuromuscular-blocking_drug
https://en.wikipedia.org/wiki/Anesthesia_awareness
Specifically, neuromuscular blockers is what you seem to be referring to. Those paralyze only muscle, not other organs, and therefore have little influence on intestines. They are of multiple uses to both the anesthesiologist (intubation) and surgeons (easier to reach places normally crammed up by active muscle). There are ways to reduce intestinal activity specifically, but those are not very efficient (glucagon).
As for awareness situations, you are right in that they are more likely with neuromuscular blockers on board. However, research shows that the surgical context is of great importance, and situations where:
- the patient is perceived as most fragile (cardiac surgery)
- or where things go too fast (emergency C-section)
are most at risk, due respectively to fear of overdose in fragile patients and immediate threat to life to the unborn child.Detection of true awareness is difficult, since many people will tell you they woke up during surgery while it was in fact the end of surgery (from personal experience). It is not known how frequent true awareness really is, but it is commonly accepted to be quite rare, and this goes along with my personal experience.
If you are reasonably healthy, the chance of true awareness during surgery is IMO vanishingly small.
Civil war soldiers did indeed not have neuromuscular blockers, but since efficient sleep medication did not exist, true awareness was far more frequent (probably the norm, in fact).