On Awakening Paralyzed During Surgery

To the Editor.— While one or more cases reported by Dr Blacher (234:67, 1975) may represent the consequences of inadequate sensory anesthesia during operation, it should be emphasized that there are other more plausible explanations for the observations reported. For example, the kinds of feelings and sensations reported by Dr Blacher's patients could have developed in the postanesthesia recovery room during the course of emergence from anesthesia. The types of drugs used for anesthesia in the cases reported (ie, barbiturates, opiates, and tranquilizers) generally lead to a gradual emergence and hence ample opportunity for the sensations described to develop. Since the same types of drugs are used for premedication, it is also reasonable to expect that some of these patients' neurotic experiences occurred in the preoperative period. It is important to emphasize that Dr Blacher presented no evidence documenting postsurgical neuroses as a result of inadequate anesthesia during operation. No