Patient perspectives on intraoperative awareness with explicit recall: report from a North American anaesthesia awareness registry

Abstract

Data from this registry confirm the serious impact of anaesthesia awareness for some patients, and suggest that patients need more systematic responses and follow-up by healthcare providers.

A qualitative study of the operating room experience of patients who underwent surgery under spinal anesthesia: “It was like an adventure”

“…As a safe, easy‐to‐apply, low‐cost, non‐fasting method that provides good muscle relaxation and does not cause unconsciousness, spinal anesthesia is frequently used in perineal, abdominal, and gynecological surgery (Valsamis, Wade, Thornhill, Carey, & Ricketts, ). However, it also has certain disadvantages, such as the patients' fearing that they will lose control of their extremities and hearing the surgical team's conversations and the sounds of the devices in the operating room due to their conscious state (Kent et al, ; Kömürcü et al, ).…”

“…People in this process are concerned about not being able to protect her/his privacy, and they also need more information and attention (Sundqvist, Holmefur, Nilsson, & Anderzén‐Carlsson, ). Surgical interventions lead to psychological and physiological changes in patients (Kent et al, ; Kömürcü et al, ; Sundqvist et al, ). Patient reactions may also differ depending on the type of surgery (Sigdel, ).…”

“…Prior to surgery, patients' anxiety may be caused by various factors, including the unknown nature of the process, possibility of medical errors resulting in disability or death, pain, economic loss, anesthesia and being conscious during anesthesia, complications such as bleeding, and the foreign environment (Bansal & Joon, ). In addition, the conscious state of patients undergoing spinal anesthesia may increase their level of anxiety, making them feel even more vulnerable and fragile (Karlsson, Ekebergh, Mauléon, & Almerud Österberg, ; Kent et al, ). Such anxiety may be further intensified due to the application of an intravenous cannula, anesthetic injection into the spine, being able to witness the operation, and feeling pain (Bheemanna, Channaiah, Gowda, Shanmugham, & Chanappa, ).…”

Brain Monitored Propofol Ketamine for Elective Cosmetic Surgery

“…It is an untenable assertion that 16 million of the 40 million (40%) American patients every year emerge from anesthesia with "brain fog" caused by a previously undiagnosed, underlying condition. Without numerically measuring the depth of sedation/anesthesia, discovering the role of routine overmedication in postoperative "brain fog" will be problematic [3]. A blanched surgical field does not equal adequate local analgesia.…”

Memory and awareness in anaesthesia

“…A report from the Anesthesia Awareness Registry of the American Society of Anesthesiologists indicates that explicit recall of intraoperative awareness can have significant negative psychological impact on patients, which suggests that a more systematic response and follow-up care are necessary. 20 Amongst the irreplaceable roles of the MAA conferences has been, and hopefully will continue to be, an investigation into subconscious processing of information during anaesthesia. Now that we have abundant, if not sufficient, evidence for anaesthetic-induced unconsciousness, we should investigate further the science of subconsciousness.…”