This article needs more reliable medical references for verification or relies too heavily on primary sources. Please review the contents of the article and add the appropriate references if you can. Unsourced or poorly sourced material may be challenged and removed. Find sources: "Anesthesia awareness" – news · newspapers · books · scholar · JSTOR(April 2014)
Awareness under anesthesia, also referred to as intraoperative awareness or accidental awareness during general anesthesia (AAGA), is a rare complication of general anesthesia where patients regain varying levels of consciousness during their surgical procedures. While anesthesia awareness is possible without resulting in any long-term memory of the experience, it is also possible for victims to have awareness with explicit recall, where they can remember the events related to their surgery (intraoperative awareness with explicit recall).[1]
Intraoperative awareness with explicit recall is an infrequent condition with potentially devastating psychological consequences.[2] While it has gained popular recognition in media, research shows that it only occurs at an incidence rate of 0.1–0.2%. Patients report a variety of experiences, ranging from vague, dreamlike states to being fully awake, immobilized, and in pain from the surgery. Intraoperative awareness is usually caused by the delivery of inadequate anesthetics relative to the patient's requirements. Risk factors can be anesthetic (e.g., use of neuromuscular blockade drugs, use of intravenous anesthetics, technical/mechanical errors), surgical (e.g., cardiac surgery, trauma/emergency, C-sections), or patient-related (e.g., reduced cardiovascular reserve, history of substance use, history of awareness under anesthesia).
Currently, the mechanism behind consciousness and memory under anesthesia is unknown, although there are many working hypotheses. However, intraoperative monitoring of anesthetic level with bispectral index (BIS) or end-tidal anesthetic concentration (ETAC) may help to reduce the incidence of intraoperative awareness, although clinical trials have yet to show a decreased incidence of AAGA with the BIS monitor.[3]
There are also many preventative techniques considered for high-risk patients, such as pre-medicating with benzodiazepines, avoiding complete muscle paralysis, and managing patients' expectations. Diagnosis is made postoperatively by asking patients about potential awareness episodes and can be aided by the modified Brice interview questionnaire. A common but devastating complication of intraoperative awareness with recall is the development of post-traumatic stress disorder (PTSD) from the events experienced during surgery. Prompt diagnosis and referral to counseling and psychiatric treatment are crucial to the treatment of intraoperative awareness and the prevention of PTSD.
^Mashour GA, Avidan MS (July 2015). "Intraoperative awareness: controversies and non-controversies". British Journal of Anaesthesia. 115 (Suppl 1): i20–i26. doi:10.1093/bja/aev034. PMID 25735710.
^Almeida D (December 2015). "Awake and unable to move: what can perioperative practitioners do to avoid accidental awareness under general anaesthesia?". Journal of Perioperative Practice. 25 (12): 257–61. doi:10.1177/175045891502501202. PMID 26845787. S2CID 2682608.
^Butterworth, John F.; Mackey, David C.; Wasnick, John D. (2022). Morgan & Mikhail's Clinical Anesthesiology (7th ed.). McGraw Hill. p. 1268. ISBN 978-1-260-47379-7.
and 25 Related for: Anesthesia awareness information
Awareness under anesthesia, also referred to as intraoperative awareness or accidental awareness during general anesthesia (AAGA), is a rare complication...
to wake up. Anesthesiaawareness occurs when general anesthesia is inadequately maintained, for a number of reasons. Typically, anesthesia is 'induced'...
differences) is a drug used to induce anesthesia — in other words, to result in a temporary loss of sensation or awareness. They may be divided into two broad...
General anaesthesia (UK) or general anesthesia (US) is a method of medically inducing loss of consciousness that renders a patient unarousable even with...
following outline is provided as an overview of and topical guide to anesthesia: Anesthesia – pharmacologically induced and reversible state of amnesia, analgesia...
Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may...
in a more rapid emergence from anesthesia. Use of the BIS monitor could reduce the incidence of intraoperative awareness during anaesthesia. The exact...
intravenous anesthesia (TIVA) refers to the intravenous administration of anesthetic agents to induce a temporary loss of sensation or awareness. The first...
consciousness after death. An anesthesiologist who examined the case offered anesthesiaawareness as a more prosaic and conventional explanation for such claims. Reynolds...
administers anesthesia for surgery or other medical procedures. Nurse anesthetists (NA's) administer or participate in administration of anesthesia services...
use of neuromuscular blocking drugs carries with it the risk of anesthesiaawareness. There are dozens of plants from which isoquinoline and indole alkaloids...
Carol Weihrer (born c. 1951) is an activist for victims of anesthesiaawareness. Beginning in 1989, Weihrer had chronic pain from recurrent corneal erosion...
surgical procedures or certain diagnostic imaging studies. General Anesthesia: General anesthesia involves a drug-induced state during which patients are unarousable...
practice nurse who administers anesthesia in the United States. CRNAs account for approximately half of the anesthesia providers in the United States...
sort of mask, medical practitioners, medical uniforms, hospital gowns, anesthesia, intimate examinations (such as rectal examination, gynecological examination...
Local anaesthesia Mechanical ventilation Intraoperative awareness History of general anesthesia Franks, Nicholas P. (May 2008). "General anaesthesia: from...
Obstetric anesthesia or obstetric anesthesiology, also known as ob-gyn anesthesia or ob-gyn anesthesiology, is a sub-specialty of anesthesiology that...
perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine...
cognition, experience, feeling or perception. It may be awareness, awareness of awareness, or self-awareness either continuously changing or not. The disparate...
World Anesthesia Day or World Anaesthesia Day, also known in some countries as National Anaesthesia Day or Ether Day, is an annual event celebrated around...
Situational awareness or situation awareness (SA) is the understanding of an environment, its elements, and how it changes with respect to time or other...
measure physiological and cognitive self-awareness. However, agreement has been reached that animals can be self-aware in ways not measured by the mirror test...
An anaesthetic machine (British English) or anesthesia machine (American English) is a medical device used to generate and mix a fresh gas flow of medical...
barbiturate and has been used commonly in the induction phase of general anesthesia. Its use has been largely replaced with that of propofol, but may retain...
donor's heart was still beating and the body exhibited signs of anesthesiaawareness. Now, Peter devises what he calls a superEEG in order to determine...
Global Information
