Intraoperative awareness: from neurobiology to clinical practice

Intraoperative awareness is defined by both consciousness and explicit memory of surgical events. Although electroencephalographic techniques to detect and prevent awareness are being investigated, no method has proven uniformly reliable. The lack of a standard intraoperative monitor for the brain likely reflects our insufficient understanding of consciousness and memory. In this review, the authors discuss the neurobiology of consciousness and memory, as well as the incidence, risk factors, sequelae, and prevention of intraoperative awareness.