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Chapter 90 - Awareness under Anesthesia

from Section 12 - Post-Anesthesia Care Unit

Published online by Cambridge University Press:  03 August 2023

By
Kaitlyn Jakubec ,
Jessica A. Lovich-Sapola  and
Donald M. Voltz
Edited by
Jessica A. Lovich-Sapola
Jessica A. Lovich-Sapola
Affiliation:
Cleveland Clinic, Ohio
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Summary

A 46-year-old female with temporal-mandibular joint (TMJ) disease presents for a TMJ arthroplasty. This patient is a 155 cm, 62 kg woman with no known allergies or medical problems. She conveys to you that when she underwent a tubal ligation 7 years ago she remembers waking up during the surgery. As she describes her previous anesthetic misadventure, her anxiety level increases. What do you make of the previous anesthetic history in this patient? What would you tell this patient to alleviate her fears for this surgery? What are your anesthetic plan and management options for a patient with a prior episode of anesthetic awareness? What patients are at the highest risk of experiencing awareness under anesthesia?

Type
Chapter
Information
Anesthesia Oral Board Review
Knocking Out The Boards
 , pp. 376 - 378
Publisher: Cambridge University Press
Print publication year: 2023

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References

Bischoff, P, Rundshagen, I. Awareness under general anesthesia. Dtsch Arztebl Int 2011;108(1–2): 1–7.Google ScholarPubMed
Cascella, M, Bimonte, S, Amruthraj, NJ. Awareness during emergence from anesthesia: features and future research directions. World J Clin Cases. 2020;8(2):245–54.CrossRefGoogle ScholarPubMed
Griffith, D, Jones, JB. Awareness and memory in anaesthetized patients. Br J Anaesth 1990;65:603–7.Google Scholar
Sebel, PS. Awareness and memory during general anesthesia. ASA Annual Meeting Refresher Course Lectures, 2007.Google Scholar
Tasbihgou, SR, Vogels, MF, Absalom, AR. Accidental awareness during general anaesthesia: a narrative review. Anaesthesia 2018;73:112–22.CrossRefGoogle ScholarPubMed
Wang, M, Messina, AG, Russell, IF. The topography of awareness: a classification of intra-operative cognitive states. Anaesthesia 2012;67:1197–201.CrossRefGoogle ScholarPubMed

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