Intraoperative awareness during paediatric anaesthesia. British Journal of Anaesthesia 102 (1): 104 – 10 (2009). Background. Intraoperative awareness refers to a patient ’ s explicit recall of events during a procedure performed under general anaesthesia.
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Intraoperative awareness during paediatric anaesthesia
British Journal of Anaesthesia 102 (1): 104–10 (2009)
the case was classified as a true awareness case.
entirely at the discretion of the attending anaesthetist.
after which they were transferred to the operation theatre.
using an adapted interview from Brice and colleagues
7 (Appendix 1).
if the child could not respond to an open question.
For every case of suspected awareness, a report was made with the child’s age and sex, details of the operation, and memories described in the child’s own words. After the end of the study, all reports were sent to four experienced paediatric anaesthetists in different university hospitals in the Netherlands. These adjudicators independently rated the cases as ‘awareness’, ‘possible awareness’, or ‘no awareness’. If all four adjudicators rated a case as ‘awareness’,then it was defined as a ‘true awareness’ case. If at least one adjudicator classified the case as awareness, the case was defined as a ‘possible awareness’ case.
Experiences of 26 children (11 boys and 15 girls) were identified as ‘suspected awareness’. The four adjudicators rated six of these cases as ‘true awareness’ (Table 2, Cases1–6), resulting in an incidence of true awareness of 0.6%(95% confidence interval 0.03–1.40%). Eight cases(0.8%) were classified as ‘possible awareness’ (Table 2,Cases 7–14). The overall incidence of true and possible awareness combined was 1.5% (95% confidence interval 0.90–2.50%).
and severe pain during surgery, respectively
anaesthesia. Ten of these (2.7%), six boys and four girls,
reported they had experienced awareness at the time.
experience 5 yr earlier during two different operations.
awareness group had sleeping problems and nightmares
for 2 weeks, which had resolved at the time of the final
The incidence of awareness in this study, in children undergoing general anaesthesia, is comparable with recent reports from other countries, and appears to be higher than that reported in adults.