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Anesthesia & Analgesia, Vol 86, 1084-1089, Copyright © 1998 by International Anesthesia Research Society
Awareness with recall during general anesthesia: incidence and risk factors
SO Ranta, R Laurila, J Saario, T Ali-Melkkila and M Hynynen
Department of Anaesthesia, Children's Hospital, Helsinki University Central Hospital, Finland. seppo.ranta@huch.fi
We studied the associated factors and incidence of awareness during general
anesthesia and the nature of subsequent psychiatric disorders. Patients
older than 12 yr undergoing surgery under general anesthesia in a secondary
care hospital during 1 yr were included in the study. The doses of
anesthetics were calculated for the patients with and without awareness.
There were 4818 operations under general anesthesia; 2612 (54%) patients
were interviewed. Ten (0.4% of those interviewed) patients were found to
have undisputed awareness, and there were nine (0.3%) patients with
possible awareness. The doses of isoflurane (P < 0.01) and propofol (P
< 0.05) were smaller in patients with awareness. Five patients with
awareness underwent a psychiatric evaluation. One patient experienced sleep
disturbances afterward, but the other four patients did not have any after
effects. In conclusion, awareness is a rare complication of general
anesthesia associated with small doses of anesthetics. Implications: In an
interview of 2612 patients after general anesthesia, 10 (0.4%) patients
with awareness and 9 (0.3%) patients with possible awareness were found. A
predisposing factor was small doses of the principal anesthetic. In a
psychiatric interview, a large proportion of the patients with awareness
were found to have suffered from depression in the past.
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