patient persepectives on intraoperative awarenes ith explicit recall: report from a north american

Awareness during general anaesthesia (GA) with explicit recall has been reported to occur with a frequency of 1–2 per 1000 patients during general surgery, when the Brice methodology is utilized for case identification. 1, 2 Although uncommon, awareness is a source of concern for both patients and anaesthetists with potential for psychological 3, 4, 5, 6, 7 and medicolegal 7, 8 sequelae.

Full Answer

Abstract

Awareness during general anaesthesia is a source of concern for patients and anaesthetists, with potential for psychological and medicolegal sequelae. We used a registry to evaluate unintended awareness from the patient's perspective with an emphasis on their experiences and healthcare provider responses.

Methods

This study was approved by the University of Washington Institutional Review Board. Written informed consent was obtained from subjects who mailed in Registry materials. The requirement for written informed consent was waived by the review board for subjects who submitted their information online.

Results

From a total of 312 respondents who completed surveys from December 2007 to August 2014, about recall of events during anaesthesia, medical records were available from 103. Almost all were from North America.

Discussion

This study reports findings from the Anesthesia Awareness Registry, a unique international registry that focuses on anaesthesia awareness from the patient-centered perspective. Most (75%) respondents were dissatisfied with how physicians and nurses responded to their report of awareness.

Supplementary material

Supplementary material is available at British Journal of Anaesthesia online.

Declaration of interest

C.D.K., K.L.P., G.A.M., S.L.M., R.R.B., A.E.H., and K.B.D. have no commercial or financial conflicts of interest to report. GAM is on the editorial boards of Anesthesiology, Canadian Journal of Anesthesia, Journal of Neurosurgical Anesthesiology, and Sleep, and was a past editorial board member of Anesthesia & Analgesia. K.B.D.

Funding

This report was supported in part by the ASA and Anesthesia Quality Institute (AQI), both in Schaumburg, IL USA. Neither organization had any role in study design, collection analysis and interpretation of data, writing the report, or decision to submit report for publication.

What is the N#A North American registry for anaesthesia awareness?

•#N#A North American registry for anaesthesia awareness was analysed for patient experiences and care team responses to the event. #N#•#N#Of 68 subjects reporting awareness during general anaesthesia most experienced auditory recall and inability to move.#N#•#N#Most respondents were dissatisfied with the way their experience was managed, and would prefer clear communication, experience validation, and follow-up.

What is awareness during general anaesthesia?

Awareness during general anaesthesia is a source of concern for patients and anaesthetists, with potential for psychological and medicolegal sequelae. We used a registry to evaluate unintended awareness from the patient’s perspective with an emphasis on their experiences and healthcare provider responses.

What is AWR complication?

The complication of AWR continues to occur during intended general anesthesia. Many reports of AWR episodes occur in patients receiving sedation or regional anesthesia and relate to incorrect expectations regarding anesthetic techniques and conscious experiences, representing a potential target for intervention.

What is AWR in anesthesia?

Unintended intraoperative awareness with recall (AWR) is a potential complication of general anesthesia. Patients typically report recollections of (1) hearing sounds or conversations, (2) being unable to breathe or move, (3), feeling pain, and/or (4) experiencing emotional distress. The purpose of the current study was to identify and further characterize AWR experiences identified through postoperative surveys of a large unselected adult surgical cohort.

Abstract

• Awareness during general anaesthesia (GA) with explicit recall has been reported to occur with a frequency of 1–2 per 1000 patients during general surgery, when the Brice methodology is utilized for case identification.1,2 Although uncommon, awareness is a source of concern for both patients and anaesthetists with potential for psychological3–7 and...

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Methods

Results

Discussion

Authors' Contributions

Declaration of Interest

Funding

Acknowledgments