European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Awareness with recall (AWR), originally coined as intra-operative awareness, is a recognized risk of general anesthesia (GA). Based on individual factors, patients respond differently to GA. The safety of GA has increased drastically over the past 20 years; however, there is continued opportunity for assessment, evaluation and treatment of AWR. Gibbs, Gibbs and Lennox (1937) first identified AWR in 1937.
Materials and Methods: The Present study was conducted at the Department of Anaesthesiology and Critical Care, Tertiary care center, Guwahati, Assam. Which includes 50 patients who underwent different routine general surgeries and 50 patients from Emergency. Pre-anaesthetic evaluation was done and noted down. In the operating room IV line established, multichannel monitor attached and standard monitoring including baseline pulse, NIBP, SPO2 and ECG connected. Entropy and NM monitoring equipment was attached. The choice of inducing agent, neuromuscular blocker and maintenance for general anaesthesia was based on the patient and nature of surgical procedure.
Results: These 200 patients were interviewed as per the protocol in hospital on the day of surgery. Our study found that among these 200 patients, 2 patients reported remembering something between going to sleep and waking up from anaesthesia, thus 2 cases of awareness were identified. 7 patients reported dreaming and 6 cases of possible awareness were identified.
Conclusion: Awareness occurs despite the usual clinical monitoring of anaesthetic depth like BP, HR and even with the use of entropy. There is currently no evidence that awareness and recall could be prevented by monitoring consciousness with sophisticated methods such as BIS or entropy. If a patient has suffered from awareness and recalls this postoperatively, psychiatric consultation and followup is recommended