5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods, and analysis of data

Abstract

The NAP5 methodology may be used to assess new reports of AAGA in a standardized manner, especially for the development of an ongoing database of case reporting. This paper is a shortened version describing the protocols, methods, and data analysis from NAP5--the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home.

The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors

“…A total of 300 reports of AAGA were made to NAP5 in the reporting period 1 June 2012 to 31 May 2013, of which 141 (47%) were considered to be certain/ probable or possible (Table 1; see accompanying paper for categorisation of AAGA reports [4]). There was a marked under-representation of children, a slight overrepresentation of younger/middle-aged adults, and an under-representation of the elderly (Fig.…”

“…Yet, in some support of the second interpretation, a number of the statement-only cases in NAP5 clearly exhibited forms of phobic avoidance for decades after AAGA [4] (see also Chapter 25 of full report: http:// www.nationalauditprojects.org.uk/NAP5Doc_NAP5_Base line_Survey_in_the_UK). The relative proportion of relatively trivial vs relatively traumatic experiences in a Brice-positive cohort is unknown and warrants formal investigation.…”

“…The methods are described in the accompanying paper [4]. For the analysis of risk factors, we compared the relative frequencies of features in AAGA reports with the frequency of those in the NAP5 activity survey [5].…”

“…Two of its stated aims included estimating an incidence of reports of AAGA and determining risk factors. The methodology is described in an accompanying paper [4] and together with its activity survey [5], makes NAP5 the largest and most comprehensive study on AAGA and its risk factors ever undertaken.…”

Beware the Boojum: the NAP5 audit of accidental awareness during intended general anaesthesia

“…Like its NAP predecessors, NAP5 has been an impressive logistical undertaking with prospectively obtained national data from the UK and Ireland over a period of a year. The results of the NAP5 audit have been summarised in three papers published in this edition of Anaesthesia [1][2][3] and simultaneously in the British Journal of Anaesthesia, with a summary of the Irish data also recently published [4] and the full report available online (see http:// www.nationalauditprojects.org.uk/ NAP5_home). This work certainly adds information to the body of knowledge about intra-operative awareness with postoperative recall, and contains the elements to forge a definitive approach to the problem of accidental awareness during intended general anaesthesia (AAGA; Fig.…”