Memory of cardiac anaesthesia

Goldmann, L.; Shah, M.V.; Hebden, M. W.

doi:10.1111/j.1365-2044.1987.tb03082.x

Cited by 111 publications

(16 citation statements)

References 20 publications

(1 reference statement)

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“…Surgical procedures typically identified as belonging to this category are cardiac, obstetric and multiple trauma surgeries [28]. Patients undergoing cardiopulmonary bypass have reported an awareness incidence from 1.1-23% [33,34]. The incidence of awareness related to obstetric anesthesia ranges from 0.4-1.3% [29,35,36].…”

Section: Risk Factormentioning

confidence: 99%

Awareness and recall during general anesthesia

Chung

2014

Korean J Anesthesiol

203

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Anesthesia awareness is defined as both consciousness and recall of surgical events. New research has been conducted out to test this phenomenon. However, testing methods have not proven reliable, including those using devices based on electroencephalographic techniques to detect and prevent intraoperative awareness. The limitations of a standard intraoperative brain monitor reflect our insufficient understanding of consciousness. Moreover, patients who experience an intraoperative awareness can develop serious post-traumatic stress disorders that should not be overlooked. In this review, we introduce the incidence of intraoperative awareness during general anesthesia and discuss the mechanisms of consciousness, as well as risk factors, various monitoring methods, outcome and prevention of intraoperative awareness.

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Section: Risk Factormentioning

confidence: 99%

Awareness and recall during general anesthesia

Chung

2014

Korean J Anesthesiol

203

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“…Finally, it has been reported that patients can comply postoperatively with instructions given during surgery for simple motor behaviors (Bennett, Davis, & Giannini, 1985;Goldmann, Shah, & Hebden, 1987), and even respond positively to therapeutic suggestions (Evans & Richardson, 1988;Furlong, 1990;Pearson, 1961). Reports such as these have kept ,alive the question of whether intraoperative events may be encoded in memory and influence postoperative experience, thought, and action, despite adequate surgical anesthesia.…”

mentioning

confidence: 99%

Implicit and Explicit Memory following Surgical Anesthesia

et al. 1990

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Paired associates were presented to 25 surgical patients following the induction of anesthesia by thiopental, vecuronium, and isoflurane. Postoperative testing (immediately or after two weeks) showed no free recall for the list; nor was there significant cued recall or recognition, compared to a matched control list. However, a free-association task showed a significant priming effect on both immediate and delayed trials. At least under some conditions, adequate surgical anesthesia appears to abolish explicit, but not implicit, memory for intraoperative events.

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“…Patients undergoing balanced anesthesia for cardiac surgery using benzodiazepines, moderate-dose fentanyl (10-15 mcg/kg), isoflurane (end-tidal concentrations 0.5%-1.5%) during anesthetic maintenance and IV propofol infusion (2-6 mg/kg/hr) during and after CPB reportedly have a relatively low incidence of awareness (0.3%; 95% CI, 0.09% to 1.19%) 20 compared with patients in the past who underwent cardiac surgery with high-dose opioid anesthesia supplemented by low dose halothane or nitrous oxide (23%; 95% CI, 11.8% to 40.9%). 22 An important caveat, apart from the wide confidence interval of the estimate, is that 0.3% was probably an underestimate because patients were only interviewed once at 18 hours postoperatively; 20 other studies have found that many patients only remember or report awareness at subsequent postoperative interviews. 18,21,23-26 While the incidence of awareness with high-dose opioid anesthesia is likely to be high, 23% is probably an over-estimate because only 30 patients were included in this study and five of the seven patients who recalled intraoperative events required hypnosis to reveal these memories.…”

Section: Intraoperative Awarenessmentioning

confidence: 98%

“…18,21,23-26 While the incidence of awareness with high-dose opioid anesthesia is likely to be high, 23% is probably an over-estimate because only 30 patients were included in this study and five of the seven patients who recalled intraoperative events required hypnosis to reveal these memories. 22 The potential problem with high-dose opioid anesthesia is that maintenance of unconsciousness is unpredictable. 27 Studies have shown that during opioid anesthesia perception and cortical processing of auditory information may not be suppressed completely.…”

Section: Intraoperative Awarenessmentioning

confidence: 99%

Brain Monitoring with Electroencephalography and the Electroencephalogram-Derived Bispectral Index During Cardiac Surgery

Kertai

Whitlock

Avidan

2012

Anesthesia &Amp; Analgesia

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Cardiac surgery presents particular challenges for the anesthesiologist. In addition to standard and advanced monitors typically used during cardiac surgery, anesthesiologists may consider monitoring the brain with raw or processed electroencephalography (EEG). There is strong evidence that a protocol incorporating the processed EEG Bispectral Index (BIS) decreases the incidence intraoperative awareness compared with standard practice. However there is conflicting evidence that incorporating the BIS into cardiac anesthesia practice improves “fast-tracking,” decreases anesthetic drug use, or detects cerebral ischemia. Recent research, including many cardiac surgical patients, shows that a protocol based on BIS monitoring is not superior to a protocol based on end tidal anesthetic concentration monitoring in preventing awareness. There has been a resurgence of interest in the anesthesia literature in limited montage EEG monitoring, including nonproprietary processed indices. This has been accompanied by research showing that with structured training, anesthesiologists can glean useful information from the raw EEG trace. In this review, we discuss both the hypothesized benefits and limitations of BIS and frontal channel EEG monitoring in the cardiac surgical population.

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Memory of cardiac anaesthesia

Abstract: Summary

Cited by 111 publications

References 20 publications

Awareness and recall during general anesthesia

Awareness and recall during general anesthesia

Implicit and Explicit Memory following Surgical Anesthesia

Brain Monitoring with Electroencephalography and the Electroencephalogram-Derived Bispectral Index During Cardiac Surgery

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