Never Ending Pursuit - Advancing Patient Safety, Satisfaction Throughout the Surgical Experience

In recognition of National Patient Safety Week March 8-14 the American Society of Anesthesiologists and the Anesthesia Awareness Campaign, are working together to educate patients on the occurrence and treatment of anesthesia awareness.

Anesthesia awareness is an uncommon condition that occurs when surgical patients under general anesthesia can recall sounds, events, or even pain during their surgery. Incidences of awareness occur once or twice per thousand surgeries performed under general anesthesia.

Not all incidences of recall during medical procedures involving anesthesia are considered cases of awareness. Patients who receive sedation, local anesthesia, regional blocks, spinal or epidural anesthesia are expected to be somewhat awake or aware of their surroundings and have some recall of the procedure. In addition at the very end of a surgical procedure, the anesthetic is reduced so that patients can awaken and therefore, there may be some awareness during this period.

The risk for anesthesia awareness is higher for unstable patients or for patients undergoing high-risk surgeries such as trauma, cardiac surgery or emergency caesarean sections. In these high-risk cases, using a deep anesthetic may not be in the best interest for patient's safety.

"Regardless of statistics, even one case of anesthesia awareness is too many. The ASA continues to study the occurrence of awareness to find effective ways to prevent the condition," said Roger A. Moore, M.D., President of the American Society of Anesthesiologists. "The entire surgical team must be vigilant before during and after surgery to ensure the safety, comfort and recovery of each patient."

Specific steps can be taken by physician and patient to reduce the risk of awareness. Patients and anesthesiologists should meet prior to surgery to discuss anesthesia options as well as the patient's surgical, anesthetic and medication history. It may be helpful for patients to have a friend or family member advocate with them for this discussion. It is during this visit that patients should discuss any anxiety or concerns about their procedure with the anesthesiologist including possible awareness.

Following surgery, patients who believe they may have experienced anesthesia awareness are encouraged to contact their anesthesiologist regarding their experience. The first step in overcoming the adverse emotional consequences of an intra-operative awareness experience is acknowledgement that it may have occurred.

Seeking greater understanding why awareness occurs, ASA has sponsored the development of The Anesthesia Awareness Database, www.awaredb.org, a voluntary registry of patients who have experienced awareness.

The Anesthesia Awareness Database was developed to understand why anesthesia awareness occurs, to prevent future occurrences awareness and to help anesthesiologists and other healthcare professionals better understand and assist patients who experience awareness.