Awareness during general anesthesia: An Indian viewpoint

Background and Aims: The incidence of intra-operative awareness with explicit recall in the Western world has been reported to be between 0.1% and 0.2% in the general surgical population and up to 1-2% of patients at high risk for this complication. Awareness in the Indian population has never been...

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Main Authors: Reshma P Ambulkar, Vandana Agarwal, Priya Ranganathan, Jigeeshu V Divatia
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2016-01-01
Series:Journal of Anaesthesiology Clinical Pharmacology
Subjects:
Online Access:http://www.joacp.org/article.asp?issn=0970-9185;year=2016;volume=32;issue=4;spage=453;epage=457;aulast=Ambulkar
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author Reshma P Ambulkar
Vandana Agarwal
Priya Ranganathan
Jigeeshu V Divatia
author_facet Reshma P Ambulkar
Vandana Agarwal
Priya Ranganathan
Jigeeshu V Divatia
author_sort Reshma P Ambulkar
collection DOAJ
description Background and Aims: The incidence of intra-operative awareness with explicit recall in the Western world has been reported to be between 0.1% and 0.2% in the general surgical population and up to 1-2% of patients at high risk for this complication. Awareness in the Indian population has never been studied; we therefore wanted to detect the incidence of awareness in patients who were at high risk of experiencing awareness during surgery in our population. Material and Methods: We conducted a prospective single-center observational study at a 600-bedded tertiary cancer care referral hospital. We recruited adult patients posted for major cancer surgery who were considered to be at high risk for awareness. These patients were interviewed at three time-points using the structured modified Brice interview questionnaire. The primary outcome studied was the incidence of definite intra-operative awareness. Results: A total of 934 patients were included in the final analysis of which none reported awareness. Using the rule of three (Hanley and Lippman-Hand) we conclude that the upper 95% confidence interval for the incidence of awareness in this population is <1 in 300 (0.33%). Conclusion: Awareness under anesthesia is a distressing complication with a potential for long-term psychological consequences, and every effort should be undertaken to prevent it. It is reassuring though that our data in Indian cancer patients at high risk for intra-operative awareness suggests that it is an uncommon occurrence.
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spelling doaj.art-2073857347a84012acc732f96d6a664a2022-12-21T18:46:44ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology0970-91852016-01-0132445345710.4103/0970-9185.173363Awareness during general anesthesia: An Indian viewpointReshma P AmbulkarVandana AgarwalPriya RanganathanJigeeshu V DivatiaBackground and Aims: The incidence of intra-operative awareness with explicit recall in the Western world has been reported to be between 0.1% and 0.2% in the general surgical population and up to 1-2% of patients at high risk for this complication. Awareness in the Indian population has never been studied; we therefore wanted to detect the incidence of awareness in patients who were at high risk of experiencing awareness during surgery in our population. Material and Methods: We conducted a prospective single-center observational study at a 600-bedded tertiary cancer care referral hospital. We recruited adult patients posted for major cancer surgery who were considered to be at high risk for awareness. These patients were interviewed at three time-points using the structured modified Brice interview questionnaire. The primary outcome studied was the incidence of definite intra-operative awareness. Results: A total of 934 patients were included in the final analysis of which none reported awareness. Using the rule of three (Hanley and Lippman-Hand) we conclude that the upper 95% confidence interval for the incidence of awareness in this population is <1 in 300 (0.33%). Conclusion: Awareness under anesthesia is a distressing complication with a potential for long-term psychological consequences, and every effort should be undertaken to prevent it. It is reassuring though that our data in Indian cancer patients at high risk for intra-operative awareness suggests that it is an uncommon occurrence.http://www.joacp.org/article.asp?issn=0970-9185;year=2016;volume=32;issue=4;spage=453;epage=457;aulast=AmbulkarAnesthesia techniqueawarenessdepth of anesthesiageneral anesthesia
spellingShingle Reshma P Ambulkar
Vandana Agarwal
Priya Ranganathan
Jigeeshu V Divatia
Awareness during general anesthesia: An Indian viewpoint
Journal of Anaesthesiology Clinical Pharmacology
Anesthesia technique
awareness
depth of anesthesia
general anesthesia
title Awareness during general anesthesia: An Indian viewpoint
title_full Awareness during general anesthesia: An Indian viewpoint
title_fullStr Awareness during general anesthesia: An Indian viewpoint
title_full_unstemmed Awareness during general anesthesia: An Indian viewpoint
title_short Awareness during general anesthesia: An Indian viewpoint
title_sort awareness during general anesthesia an indian viewpoint
topic Anesthesia technique
awareness
depth of anesthesia
general anesthesia
url http://www.joacp.org/article.asp?issn=0970-9185;year=2016;volume=32;issue=4;spage=453;epage=457;aulast=Ambulkar
work_keys_str_mv AT reshmapambulkar awarenessduringgeneralanesthesiaanindianviewpoint
AT vandanaagarwal awarenessduringgeneralanesthesiaanindianviewpoint
AT priyaranganathan awarenessduringgeneralanesthesiaanindianviewpoint
AT jigeeshuvdivatia awarenessduringgeneralanesthesiaanindianviewpoint