Psychological effects of anesthetic awareness are rare

AORN Journal,  May, 2007  

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Although cases in which patients are aware of any part of their surgery white under general anesthesia are rare, a small number of these patients have long-lasting psychological effects from the experience, according to a Jan 3, 2007, news release from the American Society of Anesthesiologists. In a study of 2,681 patients scheduled for general anesthesia between January 2001 and May 2003, 98 patients (3.7%) believed that they had experienced some awareness during a previous surgery at some time during their lives. Researchers determined that four of these cases were actually surgeries that had been performed under regional anesthesia (ie, in which a numbing agent is injected and the patient is expected to be somewhat aware). An additional 2g cases were found to be preoperative nightmares, memories of experiences before or after surgery, and other recollections that did not qualify as true anesthetic awareness. The remaining 65 patients reported experiencing auditory, tactile, and visual recollections such as

* hearing surgical team members speaking,

* being aware of intubation,

* experiencing a short period during which they felt surgical instrument use, and

* experiencing brief pain sensations.

Pain was the least common patient experience and auditory, tactile, and visual awareness were the most common. Thirty of these patients had acute emotional reactions to the awareness, and eight patients had delayed understanding of having been aware during surgery. Approximately two-thirds of the patients who experienced anesthetic awareness reported no lasting effects, but the remaining one-third reported nightmares, anxiety, or flashbacks, though for some these lasted only a few days or weeks. Only one person had symptoms indicative of post-traumatic stress disorder.

Researchers note that many of these cases occurred before anesthetic awareness was widely understood. Many patients were able to recover from the anxiety caused by experiencing anesthetic awareness after undergoing subsequent surgeries with completely successful anesthesia. Researchers hope that awareness of this phenomenon has already spread throughout the health care community and caution that the study should not be interpreted as a dismissal of the significance of anesthetic awareness.

Psychological Effects of "Anesthetic Awareness" May Linger, But Need Not Be Traumatic [news release]. Chicago, Ill; American Satiety of Anesthesiologists; January 3, 2007.

COPYRIGHT 2007 Association of Operating Room Nurses, Inc.
COPYRIGHT 2008 Gale, Cengage Learning