Accidental awareness while under general anaesthesia

Lu, Chao; Luo, Qing; Chai, Yunfei; Shu, Haihua

doi:10.5582/bst.2019.01237

Cited by 8 publications

(5 citation statements)

References 22 publications

(22 reference statements)

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“…It indicates that NT can reduce the influence of GA on the physical condition of elderly patients. The functions of various tissues and organs of patients are in an unstable state during the anesthesia recovery after GA, coupled with the intraoperative use of muscle relaxants, anesthetic residues, and the incomplete recovery of the body's protective reflex, resulting in the susceptibility to complications such as arrhythmia and POCD, which is detrimental to the postoperative outcomes of patients [ 22 , 23 ]. Furthermore, this study made statistics on AEs during anesthesia recovery and found a notably lower incidence rate in NT group.…”

Section: Discussionmentioning

confidence: 99%

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Zhang

Liu

2022

Computational and Mathematical Methods in Medicine

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Objective. This research is designed to probe into the influence of Narcotrend- (NT-) assisted anesthesia in-depth monitor on cognitive impairment of elderly patients under general anesthesia (GA). Methods. One hundred and forty-four elderly patients with GA in our hospital from October 2020 to April 2021 were randomized into two groups, namely, NT group (supervised anesthesia under NT monitoring) and group C (anesthesia according to doctors’ experience). The heart rate (HR), mean arterial pressure (MAP), and central venous pressure (CVP) were recorded before surgery (T0), at the beginning of surgery (T1), at the end of surgery (T2), and 1 day after surgery (T3). Serum of patients was obtained at these four time points for measurements of C-reactive protein (CRP), interleukin-6 (IL-6), and cortisol (Cor) levels using the enzyme-linked immunosorbent assay (ELISA). The alterations in cognitive function pre- and post-anesthesia were assessed using the mini-mental state examination (MMSE), and adverse events (AEs) during anesthesia recovery, postoperative recovery, and dosage of anesthetics were recorded. Results. At T1 and T2, MAP was higher and CVP was lower in NT group, versus group C. NT group presented higher CRP, IL-6, and Cor than group C at T1-T3. MMSE scores were higher in TN group than in group C at 12, 24, and 48 h after surgery. The incidence rates of postoperative cognitive dysfunction (POCD) and total AEs in group C were noticeably higher than those in NT group. Compared with group C, the time of anesthesia recovery, extubation, and postanesthesia care unit (PACU) residence in NT group reduced remarkably. Conclusions. NT has little effect on the physical condition of elderly patients under GA, and can reduce the dosage of narcotic drugs and promote the recovery of patients from anesthesia, which has high clinical value.

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Section: Discussionmentioning

confidence: 99%

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Zhang

Liu

2022

Computational and Mathematical Methods in Medicine

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“…The disabling symptoms of posttraumatic stress disorder (PTSD) occurred in 79% of patients who experienced AAGA [43]. The AAGA varied from 0.017 to 4%, and the relatively reliable incidence of intraoperative awareness with postoperative recall is 0.02% [44,45]. There are many factors for awareness and the insufficient anesthetic dosing was thought to be the principal cause.…”

Section: Electroencephalogram Guided Anesthetic Management and Outcomesmentioning

confidence: 99%

Double standard: why electrocardiogram is standard care while electroencephalogram is not?

Bohringer

Liu

2020

Current Opinion in Anaesthesiology

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Purpose of reviewMajor adverse cardiovascular and cerebrovascular events (MACCE) significantly affect the surgical outcomes. Electrocardiogram (ECG) has been a standard intraoperative monitor for 30 years. Electroencephalogram (EEG) can provide valuable information about the anesthetized state and guide anesthesia management during surgery. Whether EEG should be a standard intraoperative monitor is discussed in this review. Recent findingsDeep anesthesia has been associated with postoperative delirium, especially in elderly patients.Intraoperative EEG monitoring has been demonstrated to reduce total anesthesia drug use during general anesthesia and postoperative delirium. SummaryUnlike ECG monitoring, the EEG under general anesthesia has not been designated as a standard monitor by anesthesiologist societies around the world. The processed EEG technology has been commercially available for more than 25 years and EEG technology has significantly facilitated its intraoperative use. It is time to consider EEG as a standard anesthesia monitor during surgery.

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“…wareness during general anesthesia (AGA) is defined as the postoperative recall of any event that occurred during surgery. It indicates the failure to achieve the primary goals of anesthesia and has been reported as auditory perception, pain, panic, loss of motor function, and helplessness [1]. AGA is a serious problem with long-term psychological complications such as post-traumatic stress disorder, flashbacks, a tendency to avoid future medical visits and care, sleep disorders, lack of concentration, nightmares, and irritability.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

Ghanaie

Hosseinzadeh²,

Soltanipour³

et al. 2022

Caspian J Neurol Sci

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Background: General anesthesia (GA) for caesarean section (CS) has distinctive characteristics that may increase the risk of awareness during GA (AGA). Objectives: The aim of this study was to investigate the incidence of unintended awareness during GA (AGA) in CS. Materials & Methods: This cross-sectional descriptive study was performed in Alzahra Hospital in Rasht City, Iran. Eligible women with term pregnancy candidates for CS under GA were enrolled in this survey from May 2018 to August 2021. After delivery, a questionnaire including demographic data and questions related to different stages of anesthesia was completed via a faceto- face interview. The collected data were analyzed using repeated measurement, the Chi-square, Fisher exact, and t-test in SPSS v. 21. Results: The data from 174 women were analyzed, and 12 (6.9%) experienced AGA. Among them, dreaming and feeling the manipulation of the surgical area (27.8%) were the most common reported awareness states. Body mass index had a significant (P=0.034) relationship with AGA, but age (P=0.843), the level of education (P=0.714), history of anesthesia (P=0.552), 5-minute Apgar score (P=0.49), and surgery time (P=0.686) had no significant relationship with AGA. Conclusion: The incidence of AGA during CS was almost close to the high limit established by the credible evidence, and a significant number of the women were not in completely acceptable conditions. Therefore, the management of GA for CS should be revised in this academic hospital.

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Accidental awareness while under general anaesthesia

Cited by 8 publications

References 22 publications

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Influence of Narcotrend-Assisted Anesthesia In-Depth Monitor on Cognitive Impairment of Elderly Patients under General Anesthesia

Double standard: why electrocardiogram is standard care while electroencephalogram is not?

Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

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