Update on post-traumatic stress syndrome after anesthesia.

Area of Science:

• Anesthesiology
• Psychology
• Trauma Studies

Background:

• Intraoperative awareness during general anesthesia affects 0.5-2% of surgical patients.
• Awareness can lead to anxiety and potentially post-traumatic stress disorder (PTSD).

Purpose of the Study:

• To review the prevalence of PTSD following intraoperative awareness.
• To analyze patient complaints, and the type and timing of psychological assessments used.

Main Methods:

• Searched PubMed, MEDLINE, and The Cochrane Library up to October 2012.
• Included prospective and retrospective studies on adult human subjects detailing PTSD prevalence or psychological sequelae after awareness episodes.

Main Results:

• Seven studies identified a PTSD prevalence ranging from 0% to 71%.
• Acute emotions like fear and helplessness were significantly correlated with psychological sequelae, including PTSD.
• Psychological symptoms were reported from 2-6 hours to 30 days post-awakening; prior assessments lacked dissociation evaluation.

Conclusions:

• Psychological assessment, including at least three interviews at 2-6 hours, 2-36 hours, and 30 days, is recommended when intraoperative awareness is suspected.
• Future research should focus on detecting dissociative symptoms to enable prompt treatment and prevent long-term psychological disability.