Evaluation of current anaesthesia practice by assessing awareness during anaesthesia: A prospective observational study at a tertiary care teaching hospital

Abstract

Intraoperative awareness is an uncommon but extremely unfavourable occurrence affecting patients who undergo surgery under general anaesthesia. The temporary effects of awareness in some patients may be sleep disturbances, nightmares and anxiety. At times, the patients may remain fearful regarding the occurrence of awareness under anaesthesia if in future they require it. The long term effects may range from post-traumatic stress disorder to a preoccupation with death. The objective of this study was to evaluate the occurrence of intra-operative awareness in the patients with our current anaesthesia technique.1000 participants were included in this observational study, who were posted for elective or emergency surgeries or procedures under general anaesthesia. Incidence of intra-operative awareness was assessed by Brice’s Questionnaire, modified and translated according to our study design. Patients’ interview reports were classified as (a) definite awareness (b) possible awareness (c) no awareness and (d) dreaming.Out of 1000 participants, 575 (57.5%) were males and 425 (42.5%) were females. In the present study, 780 (78.0%) had elective surgery while 220 (22.0%) had emergency surgery. No intra-operative complications were seen in 844 (84.4%) patients while hypotension was seen in 77 (7.7%) patients, bleeding was seen in 47 (4.7%) and hypoxia was seen in 25 (2.5%) patients. 997 (99.7%) patients didn’t have any form of awareness during anaesthesia while two (0.2%) patients had dreaming during anaesthesia and one patient confirmed hearing voices during surgery which was considered as possible awareness according to the definition.In our study, incidence of possible awareness was found to be 0.1%. Anaesthesia experience was satisfactory among 93.7% patients. Perioperative empathetic approach towards the patients reduces the anxiety, speculations regarding surgery and anaesthesia, and this helps in minimizing the incidence of awareness during anaesthesia.