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Awareness during anaesthesia: incidence and clinical and legal aspects

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Book cover Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.

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Abstract

Until the early 1940s, before the introduction into clinical practice of neuromuscular blocking drugs, the adequacy of the depth of anaesthesia could be assessed by observing patients’ reactions to surgical stimuli in terms of gross movements, breathing activity, reflexes, and muscular tone. Furthermore, the use of highly soluble volatile agents made it possible to distinguish clearly between different levels of anaesthesia, which were accomplished quite slowly. In those circumstances, an excessive depth of anaesthesia was the main danger.

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References

  1. Tunstall ME (1997) Detecting wakefulness during general anaesthesia for caesarean section BMJ 21: 1321

    Google Scholar 

  2. Coupland TG (2003) Awareness under anaesthesia is a synonym for inadequate anaesthesia. Anaesth Intensive Care 31: 235–236

    PubMed  CAS  Google Scholar 

  3. St Pierre M, Landsleitner B, Schwilden H et al (2000) Awareness during laryngoscopy and intubation: quantitating incidence following induction of balanced anesthesia with etomidate and cisatracurium as detected with the isolated forearm technique. J Clin Anesth 12: 104–108

    Article  Google Scholar 

  4. Munte S, Munte TF, Mitzlaff B et al (2001) Postoperative reading speed does not indicate implicit memory in elderly cardiac patients after propofol and remifentanil anaesthesia. Acta Anaesthesiol Scand 45: 750–755

    Article  PubMed  CAS  Google Scholar 

  5. Evans JM, Davies WL, Wise CC (1984) Lower oesophageal contractility: a new monitor of anaesthesia. Lancet I: 1151–1154

    Google Scholar 

  6. Chang T, Dworsky WA, White PF (1988) Continuous electromyography for monitoring depth of anaesthesia. Anesth Analg 67: 521–525

    Article  PubMed  CAS  Google Scholar 

  7. Schultz B, Schultz A (2002) EEG monitoring improves quality and safety of TIVA. Anaesth Intensive Care 30: 817–818

    PubMed  CAS  Google Scholar 

  8. Muncaster AR, Sleigh JW, Williams M (2003) Changes in consciousness, conceptual memory, and quantitative electroencephalographical measures during recovery from sevoflurane-and remifentanil-based anesthesia. Anesth Analg 96: 720–725

    Article  PubMed  CAS  Google Scholar 

  9. Lehmann A, Karzau J, Boldt J et al (2003) Bispectral index-guided anesthesia in patients undergoing aortocoronary bypass grafting. Anesth Analg 96: 336–343

    PubMed  Google Scholar 

  10. Bergman IJ, Kluger MT, Short TG (2002) Awareness during general anaesthesia: a review of 81 cases from the Anaesthetic Incident Monitoring Study. Anaesthesia 57: 549–556

    Article  PubMed  CAS  Google Scholar 

  11. Rosenblatt M, Van Ness Jw (1972) Estimation of the bispectrum. Ann Math Stat 36: 1120–1136

    Article  Google Scholar 

  12. Rampil IJ (1998) A primer for EEG signal processing in anaesthesia. Anesthesiology 89: 980–1002

    Article  PubMed  CAS  Google Scholar 

  13. Kerssens C, Lubke GH, Klein J et al (2002) Memory function during propofol and alfentanil anesthesia: predictive value of individual differences. Anesthesiology 97: 382–389

    Article  PubMed  CAS  Google Scholar 

  14. Drover DR, Lemmens HJ, Pierce ET et al (2002) Patient State Index: titration of delivery and recovery from propofol, alfentanil, and nitrous oxide anesthesia. Anesthesiology 97: 82–89

    Article  PubMed  Google Scholar 

  15. Luginbuhl M, Schnider TW (2002) Detection of awareness with the bispectral index: two case reports. Anesthesiology 96: 241–243

    Article  PubMed  Google Scholar 

  16. Thornton C, Sharpe RM (1998) Evoked responses in anaesthesia. Br J Anaesth 81: 771–781

    Article  PubMed  CAS  Google Scholar 

  17. Bailey AR, Jones JG (1997) Patients’ memories of events during general anaesthesia. Anaesthesia 52: 460–476

    Article  PubMed  CAS  Google Scholar 

  18. Schwender D, Klasing S, Madler C et al (1993) Effects of benzodiazepines on mid-latency auditory evoked potentials. Br J Anaesth 71: 622–628

    Article  PubMed  CAS  Google Scholar 

  19. Schwender D, Klasing S, Madler C et al (1993) Effects of increasing doses of alfentanil, fentanyl and morphine on mid-latency auditory evoked potentials. Can J Anaesth 40: 1148–1154

    Article  PubMed  CAS  Google Scholar 

  20. Schwender D, Klasing S, Madler C et al (1993) Mid-latency auditory evoked potentials during ketamine anaesthesia in humans. Br J Anaesth 71: 629–632

    Article  PubMed  CAS  Google Scholar 

  21. Aceto P, Valente A, Gorgoglione M et al (2003) Relationship between awareness and middle latency auditory evoked responses during surgical anaesthesia. Br J Anaesth 90: 630–635

    Article  PubMed  CAS  Google Scholar 

  22. Absalom AR, Sutcliffe N, Kenny GN (2001) Effects of the auditory stimuli of an auditory evoked potential system on levels of consciousness and on the bispectral index. Br J Anaesth 87: 778–780

    Article  PubMed  CAS  Google Scholar 

  23. Loveman E, Van Hooff JC, Smith DC (2001) The auditory evoked response as an awareness monitor during anaesthesia. Br J Anaesth 86: 513–518

    Article  PubMed  CAS  Google Scholar 

  24. Maattanen H, Anderson R, Uusijarvi J et al (2002) Auditory evoked potential monitoring with the AAITM-index during spinal surgery: decreased desflurane consumption. Acta Anaesthesiol Scand 46: 882–886

    Article  PubMed  CAS  Google Scholar 

  25. Ghoneim MM, Block RI, Dhanaraj VJ et al (2000) Auditory evoked responses and learning and awareness during general anesthesia. Acta Anaesthesiol Scand 44: 133–143

    Article  PubMed  CAS  Google Scholar 

  26. Ori C, Dam M, Pizzolato G et al (1986) Effects of isoflurane anaesthesia on local cerebral glucose utilization in the rat. Anesthesiology 65: 152–156

    Article  PubMed  CAS  Google Scholar 

  27. Dam M, Ori C, Pizzolato G et al (1990) The effects of propofol on local glucose utilization in the rat. Anaesthesiology 73: 499–505

    Article  CAS  Google Scholar 

  28. Alkire MT, Haier RJ, Barker SJ et al (1995) Cerebral metabolism during propofol anaesthesia in humans studied with positron emission tomography. Anaesthesiology 82: 393–403

    Article  CAS  Google Scholar 

  29. Alkire MT, Haier RI, Shah NK, Anderson CT (1997) Positron emission tomography study of regional cerebral metabolism in humans during isoflurane anaesthesia. Anesthesiology 86: 549–557

    Article  PubMed  CAS  Google Scholar 

  30. John ER (2002) The neurophysics of consciousness. Brain Res Brain Res Rev 39: 1–28

    Article  PubMed  Google Scholar 

  31. Cariani P (2000) Anesthesia, neural information processing, and conscious awareness. Conscious Cogn 9: 387–395

    Article  PubMed  CAS  Google Scholar 

  32. Barr G, Anderson RE, Owall A, Jakobsson JG (2001) Being awake intermittently during propofol-induced hypnosis: a study of BIS, explicit and implicit memory. Acta Anaesthesiol Scand 45: 834–838

    Article  PubMed  CAS  Google Scholar 

  33. Ori C, Meroni M, Innocente F (2002) Valutazione della profondità dell’anestesia. In: Gullo A (ed) Medicina perioperatoria, terapia intensiva, emergenze. Springer Italia, Milan, pp 189–198

    Google Scholar 

  34. Ghoneim MM (2000) Awareness during anesthesia. Anesthesiology 92: 597–602

    Article  PubMed  CAS  Google Scholar 

  35. MacClaurin SC (2002) Awareness under TIVA. Anaesth Intensive Care 30: 816

    PubMed  CAS  Google Scholar 

  36. Ranta SO, Hynynen M, Rasanen J (2002) Application of artificial neural networks as an indicator of awareness with recall during general anaesthesia. J Clin Monit Comput 17: 53–60

    Article  PubMed  Google Scholar 

  37. Wennervirta J, Ranta SO, Hynynen M (2002) Awareness and recall in outpatient anesthesia. Anesth Analg 95: 72–77

    Article  PubMed  Google Scholar 

  38. Palm S, Linstedt U, Petry A et al (2001) Dose-response relationship of propofol on mid-latency auditory evoked potentials ( MLAEP) in cardiac surgery. Acta Anaesthesiol Scand 45: 1006–1010

    Article  PubMed  CAS  Google Scholar 

  39. Spitellie PH, Holmes MA, Domino KB (2002) Awareness during anaesthesia. Anesthesiol Clin North Am 20: 555–570

    Article  Google Scholar 

  40. Leslie K, Lee L, Myles PS, Lerch N et al (2003) Patients’ knowledge of and attitudes towards awareness and depth of anaesthesia monitoring. Anaesth Intensive Care 3163–3168

    Google Scholar 

  41. Spitellie PH, Holmes MA, Domino KB (2002) Awareness during anesthesia. Anesthesiol Clin North Am 20: 317–332

    Article  Google Scholar 

  42. Yli-Hankala A (2000) Operating theatre — the patient is listening. Acta Anaesthesiol Scand 44: 131–132

    Article  PubMed  CAS  Google Scholar 

  43. Enlund M, Hassan HG (2002) Intraoperative awareness: detected by the structured Brice interview? Acta Anaesthesiol Scand 46: 345–349

    Article  PubMed  CAS  Google Scholar 

  44. Lennmarken C, Bildfors K, Enlund G et al (2002) Victims of awareness. Acta Anaesthesiol Scand 46: 229–231

    Article  PubMed  CAS  Google Scholar 

  45. Ho AM (2001) ‘Awareness’ and ’recall’ during emergence from general anaesthesia. Eur J Anaesthesiol 18:623–625

    Google Scholar 

  46. Schou J (2000) Awareness during anaesthesia. Lancet 13: 1723

    Article  Google Scholar 

  47. Gilston A (2000) Awareness during anaesthesia. Lancet 13: 1722

    Article  Google Scholar 

  48. Buerkle H, Wuesten R (2000) Awareness during anaesthesia. Lancet 13: 1721–1722

    Article  Google Scholar 

  49. Downie P, Avidan M (2000) Awareness during anaesthesia. Lancet 13: 1721

    Article  Google Scholar 

  50. Sandin RH, Enlund G, Samuelsson P et al (2000) Awareness during anaesthesia: a prospective case study. Lancet 26: 707–711

    Article  Google Scholar 

  51. Simini B (2000) Awareness of awareness during general anaesthesia. Lancet 26: 672–674

    Article  Google Scholar 

  52. Metz S (2000) Awareness during cardiac surgery. J Cardiothorac Vasc Anesth 14: 107–108

    Article  PubMed  CAS  Google Scholar 

  53. Domino KB, Posner KL, Caplan RA et al (1999) Awereness during anaesthesia: a closed claims analysis. Anesthesiology 90: 1053–1061

    Article  PubMed  CAS  Google Scholar 

  54. Ghoneim MM (2000) Awareness during anaesthesia. Anesthesiology 92: 597–602

    Article  PubMed  CAS  Google Scholar 

  55. Domino KB, Aitkenhead AR (2001) Medicolegal consequences of awareness during anesthesia. In: Goneim MM (ed) Awareness during anaesthesia. Butterworths, London, pp 155–172

    Google Scholar 

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Authors
  1. C. Ori
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  2. A. Roncarati
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  3. S. Rizzi
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Editor information

Editors and Affiliations

  1. Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Trieste, Italy

    Antonino Gullo M.D. (Head) (Head)

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© 2004 Springer-Verlag Italia, Milano

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Ori, C., Roncarati, A., Rizzi, S. (2004). Awareness during anaesthesia: incidence and clinical and legal aspects. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2189-1_10

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  • DOI: https://doi.org/10.1007/978-88-470-2189-1_10

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0235-7

  • Online ISBN: 978-88-470-2189-1

  • eBook Packages: Springer Book Archive

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