[Awareness anesthesia--an anesthesiologic dilemma]

Awareness is a traumatic unintentional event during general anaesthesia. Awareness during anaesthesia is a condition which ranges from a state of alertness to deep anaesthesia with partly preserved senses. Awareness can be divided into four groups, depending on the state of alertness and accessibility of the memories after anaesthesia. Diagnostics and follow-up is complicated when awareness with an impaired recall occurs. We conclude that the incidence of awareness has decreased during the last three decades from approximately 1.5% to 0.2% during general surgery. In clinical practice there is no method for the detection of depth of anaesthesia and no anaesthetic technique that prevents awareness during anaesthesia. Guidelines to further reduce the incidence are suggested. Instant treatment of the condition may relieve the acute trauma and reduce the sequelae. We suggest a postoperative visit to ensure quality development for recording and treatment of awareness during anaesthesia.