Anesthetic Awareness

Question 1

What is anesthetic awareness?

Answer 1

Recollection of experiences during a period of intended general anesthesia.

Question 2

What are the clinical features of anesthetic awareness intraoperatively?

Answer 2

hypertension
tachycardia
diaphoresis
pain
sensation of paralysis/weakness
hearing noises/voices
feelings of panic, helplessness, impending death

Question 3

What are the clinical feaures of anesthetic awareness postoperatively?

Answer 3

nightmares
sleep disturbances
anxiety
fear of future anesthesia

Question 4

What might have caused true awareness in a patient who was supposed to be under general anesthesia?

Answer 4

equipment problems
drug errors
deliberate light anesthesia (as might be done during a crisis)
prolonged intubation

Question 5

What is the cause of “anesthetic awareness” under sedation or regional anesthesia?

Answer 5

communication breakdown between practitioner and patient

Question 6

What is the differential diagnosis of presumed anesthetic awarenses?

Answer 6

1. true awareness
2. awareness under sedation/regional anesthesia
3. secondary gain

Question 7

What is the management of suspected awareness during surgery?

Answer 7

stop surgery
verbally reassure
deepen anesthesia
amnestic medications

Question 8

What is the postoperative management of a patient who had awareness while supposed to be under general anesthesia?

Answer 8

interview
reassure
disclose/explain circumstances
arrange follow-up/counseling