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Unintentional intraoperative awareness during sufentanil anaesthesia for cardiac surgery

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The aim of this clinical report is to describe a case of unintentional intraoperative awareness during sufentanil anaesthesia in a patient undergoing elective aortocoronary bypass grafting.

Clinical findings

After premedication with morphine (5 mg) and scopolamine (0.2 mg), this 51-yr-old woman received sufentanil (10 μg · kg−1), midazolam (4 mg) and isoflurane (0.3–0.4% end-tidal). The patient recalled specific events and discussions which took place in the operating room during surgery. This patient’s report was clear and corroborated by operating room personnel. The patient denied having felt pain, anxiety or emotional distress.


Although awareness during opioid anaesthesia has been previously described with morphine and fentanyl, as far as we know this is the first clinical report of awareness with sufentanil. Given that recent efforts of early extubation in cardiac surgery patients may involve a reduction in the amount of opioid administered, this report serves as a reminder of the ever present potential for this disturbing complication.



Rapporter une observation de reprise accidentelle de la conscience pendant l’anesthésie au sufentanil d’une patiente opérée pour une chirurgie de revascularisation myocardique non urgente.

Constatations cliniques

Après une prémédication à la morphine (5 mg) et à la scopolamine (0,2 mg) cette patiente de 51 ans a reçu du sufentanil (10 μg · kg−1), du midazolam (4 mg) et de l’isoflurane (téléexpiratoire 0,2–0,4%). La patiente s’est souvenue des événements spécifiques et des discussions qui se sont déroulées en salle d’opération pendant la chirurgie. Les faits rapportés étaient précis et ont été corroborés par le personnel de la salle d’opération. La patiente a nié avoir ressenti de la douleur, de l’anxiété ou de la détresse émotionnelle.


La reprise de conscience a déjà été rapportée avec la morphine et le fentanyl, mais d’après les auteurs, il s’agit ici du premier cas mettant en cause le sufentanil. Etant donné la tendance actuelle vers l’extubation précoce pouvant nécessiter une réduction de la quantité de morphinique, l’observation actuelle nous rappelle le danger constant de cette inquiétante complication.


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Correspondence to G. Plourde.

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Gilron, I., Solomon, P. & Plourde, G. Unintentional intraoperative awareness during sufentanil anaesthesia for cardiac surgery. Can J Anaesth 43, 295–298 (1996). https://doi.org/10.1007/BF03011746

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Key words

  • anaesthetics, intravenous: sufentanil
  • complications: awareness
  • surgery: cardiac