A Study on Intraoperative Awareness and Recall During General Anaesthesia- A Prospective Observational Study

Abstract

BACKGROUNDIntraoperative awareness occurs when a patient becomes conscious during a surgical procedure performed under general anaesthesia and subsequently has recall of these events. The experience can be quite disturbing and traumatic, and some patients may even need counselling after their surgery to help lessen feelings of confusion, stress, or trauma associated with the experience. For this reason, anaesthesia professionals are seriously committed to minimising the risk of intraoperative awareness under general anaesthesia. Objectives-The purpose of this study was to evaluate the incidence of awareness with recall after surgery, which is an infrequent occurrence but of significant concern with significant adverse psychological sequelae and medicolegal implications. MATERIALS AND METHODS300 patients were enrolled for three different subsets of surgical patients undergoing general anaesthesia. An acknowledged and well-established method of detecting awareness involved the use of a structured Brice et al interview, 1970 and correlation with intraoperative Entropy monitoring. RESULTSOur study found that among these 300 patients, 2 patients reported remembering something between going to sleep and waking up from anaesthesia, thus 2 cases of awareness were identified. 7 patients reported dreaming and 4 cases of possible awareness were identified. CONCLUSIONAwareness occurs despite the usual clinical monitoring of anaesthetic depth like BP, HR and even with the use of entropy. There is currently no evidence that awareness and recall could be prevented by monitoring consciousness with sophisticated methods such as BIS or entropy. If a patient has suffered from awareness and recalls this postoperatively, psychiatric consultation and followup is recommended.