Awareness with recall (AWR) while under general anesthesia is not a frequent event—a recent report noted that it occurs in 1 to 2 cases out of 1,000. With 21 million general anesthetics administered each year, 42,000 patients have some type of recall during their procedure.1
But the effects of AWR can be severe and long-lasting. One study suggests that patients who have experienced this type of event have a 70 percent chance of developing post-traumatic stress disorder that may last for years.2
Follow these tips to help prevent AWR:
If your patient experiences awareness under anesthesia, acknowledge and address the patient’s concerns and consider referring the patient to a psychiatrist or counselor who is knowledgeable about the various types of AWR.
1 Avidan MS, Mashour GA. Prevention of intraoperative awareness with explicit recall: making sense of the evidence. Anesthesiology. 2013 Feb;118(2):449-56.
2 Leslie K, Chan MT, Myles PS, Forbes A, McCulloch TJ. Posttraumatic stress disorder in aware patients from the B-aware trial. Anesthesia and Analg. 2010 Mar 1;110(3):823-8.
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider in light of all circumstances prevailing in the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.