My patients ask this question a lot. Most people have either heard stories, watched the movie Awake, or have experienced awareness under anesthesia themselves. The fear of being awake while undergoing an operation is real. But the reality is that awareness under anesthesia is rare. There are special circumstances where it can happen; for example emergency operations where we are trying to save the patient's life, traumas, and cardiac operations. During these cases, the patient may be too unstable to handle anesthesia. Patients can be awake during surgery under local anesthesia, sedation, or regional anesthesia (like a caesarean section for surgical delivery of a baby). It is important to discuss these fears with your anesthesiologist. I reassure all of my patients that I will take good care of them. I will be monitoring them closely throughout the operation or procedure. Long before a patient has awareness under anethesia, their heartrate, respiratory rate and/or blood pressure will rise letting me know that they require more anesthesia. For procedures under sedation, I will discuss the anesthesia plan in detail with my patient. They may have moments of waking up, they may remember the operating room, or parts of the procedure, but at no time will they be uncomfortable. As always, discuss any questions or concerns and the anesthesia plan with your anesthesiologist prior to any procedure or operation. Make sure that all of your questions are answered and that you feel comfortable with the plan.