 Anesthesia awareness is a potential complication occurring during general

anesthesia where theintended state of complete unconsciousness is not

maintained throughout the whole procedure.
 so,basically,you are waking up during the surgery
 It can occur either because of failure to deliver
sufficient anesthetic medication to the patient's body, or because of individual
patient factors that mean the patient is resistant to what would normally be an
adequate dose of anesthetic medication.

Certain surgeries or circumstances increase the risk of awareness during

surgery because the usual dose of required anesthesia cannot be used safely.
These include emergency surgeries – such as C-sections, heart surgery and
trauma surgery – as well as when patients have multiple medical conditions

EXPERIENCES

 Patients with anesthetic awareness report various intraoperative experiences

In most cases they report that they were hearing conversations between the
stuff without feeling anything else.
 But there are many cases where they report pain, paralysis and anxiety
because of the fact that they feel helpless.
 An intubated patient who feels pain, although he wants to react, he is unable
to do so because of the
 The recalling of these experiences can be done immediately after surgery, in
the recovery room, or several days later, while there has been reported a
case of a patient who recalled a specific detail 5 years after the operation.

RISK FACTORS:

The main risk factors of awareness during anesthesia are:

• insufficient anesthetic medication

• different anesthetic requirements by some categories of patients

• malfunction of the anesthesia machine

PREVENTIONS:

To reduce your risk of experiencing awareness during procedures with

general anesthesia, it is important to tell your physician anesthesiologist important

health information, including:
• previous problems with anesthesia, including a history of being aware during
surgery

• all medications you are taking, both prescription,over-the-counter and herbal

supplements

• concerns you may have about surgery, including fear of being aware during
surgery

• because postoperative amnesia is not a good indicator of absence of

intraoperative awareness, all the patients must take the Brice interview

• the interview includes five questions which can diagnose a possible

awareness incident

• these questions should be asked not only shortly after operation but also
within 14 days post-operatively

Intraoperative monitoring of the anesthesia depth is important for the

prevention of this problem.

From all the available devices only the Bispectral Index Monitoring (BIS) has
been proven to be effective for this purpose but the high cost per person and
the low specificity in preventing awareness episodes do not allow its everyday
use.

very rarely – in only one or two out of every 10,000 medical procedures
involving anesthesia