Awareness (during Anaesthesia)

Last updated 10/03/15

Definition

• Patient remains conscious during an intended General Anaesthetic (GA)

Features

• Feared complication of GA
• Incidence 1:19,000
• Majority occur at induction or emergence (66%)
• Not always distressing to patient
• 50% lead to distress
• 41% lead to long term psychological harm
• Sensations experienced include
• Tugging
• Pain
• Stretching
• Paralysis
• Choking
• Feelings experienced include
• Dissociation
• Pain
• Fear
• Suffocation
• PTSD
• Brain monitors have little evidence for use

Risk Factors

• Obesity
• Total Intravenous Anaesthesia (TIVA) x2 risk of volatile gas
• Difficult airway
• Thiopental
• Muscle relaxant 93% of cases
• Emergency GA
• Female
• Obstetric, neuro or thoracic surgery

Cause

• Failure to deliver sufficient anaesthetic agent to the body
• Individual patient resistance to an otherwise sufficient dose of anaesthetic agent

Associated S/S

Complications

Investigations

Management

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References