Intraoperative awareness: detected by the structured Brice interview?

Area of Science:

• Anesthesiology
• Patient Safety

Background:

• Intraoperative awareness during general anesthesia is a rare but distressing complication.
• Awareness incidence increases with muscle relaxant use.
• Quality assurance programs aim to evaluate anesthetic techniques for awareness prevention.

Purpose of the Study:

• To evaluate the incidence of intraoperative awareness in patients undergoing short-stay surgery.
• To assess the effectiveness of the Brice interview in detecting awareness.

Main Methods:

• Prospective Brice interview of 5216 patients receiving propofol/opioid anesthesia.
• Minimal routine use of neuromuscular blockers.
• Multi-stage interviews: on recovery discharge, 3-7 days postoperatively (if needed), and 1-2 days postoperatively.

Main Results:

• No cases of intraoperative awareness were detected through patient interviews.
• Five non-relaxed patients experienced light anesthesia events without forewarning.
• Neuromuscular blockade was administered to only 7% of patients.

Conclusions:

• The study did not detect intraoperative awareness.
• A propofol/opioid anesthetic regimen with minimal muscle relaxant use may reduce awareness risk.
• Further investigation into Brice interview efficacy and timing is warranted.