How aware are you? Inadvertent awareness under anaesthesia

doi:10.1017/CBO9780511544644.009

7 - How aware are you? Inadvertent awareness under anaesthesia

Published online by Cambridge University Press: 13 August 2009

Edited by

Paul Wicker and

Brian Smith: Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Rawling: Affiliation:
Edge Hill College of Higher Education, Liverpool
Paul Wicker: Affiliation:
Edge Hill College of Higher Education, Liverpool
Chris Jones: Affiliation:
Edge Hill College of Higher Education, Liverpool

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Summary

Key learning points

Potential causes of awareness under general anaesthesia
Introduce what the incidence of awareness is believed to be
Monitor methods used to detect awareness
Appreciate the possible patient outcomes

Have you ever tried to imagine what it may feel like to be awake, yet paralysed? Have you ever experienced a dream where an event was happening to you but you were unable to respond in any way and the screams are only in your mind?

Awareness during anaesthesia is widely accepted as being defined as the spontaneous recall of events by a patient that took place during an episode of general anaesthesia. Inadvertent awareness during anaesthesia is not a new occurrence but one which has attracted increased media attention in recent years. Some 159 years ago Dr John Snow commented that:

the advent of the third degree of narcotism is marked by the cessation of all voluntary motion… … as there are no signs of ideas in this degree, I believe that there are none, and the mental faculties are completely suspended: consequently the patient is perfectly secured against mental suffering from anything that may be done

(Snow, 1847 cited in Power, 1998).

Snow's comment clearly shows that in the early days of anaesthesia the issue of awareness during surgery was given consideration. In more recent times patients have become more inclined to report episodes of awareness following anaesthesia and surgical interventions, due partly to the increase in popular media reporting.

Information

Type: Chapter
Information: Core Topics in Operating Department Practice
Anaesthesia and Critical Care
, pp. 52 - 60

DOI: https://doi.org/10.1017/CBO9780511544644.009 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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