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Awareness under general anesthesia
Onuma Chaiwat1, Kamheang Vacharaksa, Ungkab Prakanrattana
1Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.
Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|November 28, 2002
Summary
This study found that 0.62% of patients undergoing elective surgery under general anesthesia experienced awareness, likely due to inadequate anesthesia. No long-term psychological effects were observed in these patients.
Area of Science:
- Anesthesiology
- Surgical Patient Monitoring
- Postoperative Care
Background:
- Investigating the incidence and contributing factors of intraoperative awareness during general anesthesia for elective surgery.
- Assessing patient recall and psychological impact following anesthetic procedures.
Observation:
- A prospective cohort study involving 802 patients undergoing elective general and gynecological surgery under endotracheal anesthesia.
- Utilized standard monitoring and clinical observations, supplemented by interviews within 12 hours and on postoperative day 3 for suspected awareness.
- Focused on identifying clinical signs such as movement, tear production, sweating, and eyelid opening.
Findings:
- An overall incidence of 0.62% for awareness was identified, affecting 5 out of 802 patients.
- The primary clinical indicator observed in aware patients was hand movement, suggesting inadequate anesthesia.
- Auditory perception was the last memory before unconsciousness and the first upon awakening for most patients.
Implications:
- Highlights the critical need for optimized anesthesia depth to prevent intraoperative awareness.
- Suggests that auditory perception may be preserved during general anesthesia, offering a potential avenue for communication.
- Indicates that while awareness can occur, significant postoperative psychological sequelae are uncommon in this patient cohort.