The Incidence of Awareness During Anesthesia: A Multicenter United States Study

Abstract

Awareness with recall after general anesthesia is an infrequent, but well described, phenomenon that may result in posttraumatic stress disorder. There are no recent data on the incidence of this complication in the United States. We, therefore, undertook a prospective study to determine the incidence of awareness with recall during general anesthesia in the United States. This is a prospective, nonrandomized descriptive cohort study that was conducted at seven academic medical centers in the United States. Patients scheduled for surgery under general anesthesia were interviewed in the postoperative recovery room and at least a week after anesthesia and surgery by using a structured interview. Data from 19,575 patients are presented. A total of 25 awareness cases were identified (0.13% incidence). These occurred at a rate of 1-2 cases per 1000 patients at each site. Awareness was associated with increased ASA physical status (odds ratio, 2.41; 95% confidence interval, 1.04-5.60 for ASA status III-V compared with ASA status I-II). Age and sex did not influence the incidence of awareness. There were 46 additional cases (0.24%) of possible awareness and 1183 cases (6.04%) of possible intraoperative dreaming. The incidence of awareness during general anesthesia with recall in the United States is comparable to that described in other countries. Assuming that approximately 20 million anesthetics are administered in the United States annually, we can expect approximately 26,000 cases to occur each year.

The Clinical Effectiveness of the Bispectral Index (BIS) To Reduce the Risk of Awareness for Elective Surgical Patients Undergoing General Anesthesia: A Prospective, Randomized, Double-Blind, Controlled Trial

“…Our study is consistent with a study of Sebel, et al from the US which showed that an incidence of intra-operative awareness of about 0.1% to 0.2% of patients undergoing general anesthesia [22]. Our study is also in line with a study from Europe that a large prospective study conducted by Samuelsson et al who explored awareness of 11,785 patients undergoing general anesthesia.…”

“…These results are in line with Sebel et al who showed that age and gender did not affect the incidence of awareness [52]. In the contrary, a study of Katoh et al found that age strongly affected BIS points.…”

Inhibition de l’apprentissage et de la mémoire par les anesthésiques généraux

“…In turn, anesthetics are currently being used as powerful probes to gain fundamental insights into the biology and neuronal substrates of memory. Such insights may allow the development of strategies to prevent and treat memory disorders associated with anesthetic states, such as intraoperative awareness [149][150][151] and memory deficits in the postoperative period. [152][153][154] …”

Comparison of Spectral Entropy and Bispectral Index Electroencephalography in Coronary Artery Bypass Graft Surgery

“…The most frequently used electroencephalographic (EEG) device for monitoring the level of sedation during anesthesia is the bispectral index (BIS) monitor [1]. This device has been extensively studied and validated over the past 10 years in adult and pediatric cardiac anesthesia [2].…”