No evidence of long-term PTSD risk in patients with awareness during surgery

Patients with confirmed episodes of awareness during anesthesia and surgery don't seem to be at increased risk of posttraumatic stress disorder (PTSD) or other problems with psychosocial well-being at long-term follow-up, reports a study in Anesthesia & Analgesia.

"We found no indication that intraoperative awareness with recall had any long-term effects on patients' psychosocial outcome," concludes the new research by Dr Tanja Laukkala of the Centre for Military Medicine in Helsinki, Finland. Anesthesiologists "should respond to the findings…with a mixture of cautious optimism coupled with a renewed commitment to the prevention and treatment of PTSD" after intraoperative awareness, according to an editorial by Dr George A. Mashour of University of Michigan Medical School and Dr Michael S. Avidan of Washington University, St Louis.

No Long-Term Cases of PTSD after Awareness during Anesthesia The long-term follow-up study included nine patients with a documented episode of intraoperative awareness during general anesthesia. All patients had "definite awareness with recall" - they accurately described events that occurred during their surgery. The patients were identified from previous Finnish studies of intraoperative awareness.

A median of 17.2 years after their episode of intraoperative awareness, the patients were evaluated on a battery of tests of psychosocial well-being. Assessment included formal diagnostic interviews for PTSD, along with anxiety, depression, and other psychiatric disorders. Nine patients with similar characteristics - who had undergone surgery without intraoperative awareness - were studied for comparison.

The results showed no significant difference in psychosocial outcomes for the patients with versus without intraoperative awareness. In particular, none of the patients with intraoperative awareness were diagnosed with PTSD.

In fact, in no patient did the episode of intraoperative awareness meet criteria for being a "potentially traumatic event" of the type leading to PTSD. Other measures of psychosocial well-being, including quality of life ratings, were also similar between groups. A few patients in each group had depression or other psychiatric disorders.

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event - either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Many people who go through traumatic events have difficulty adjusting and coping for a while, but they don't have PTSD - with time and good self-care, they usually get better. But if the symptoms get worse or last for months or even years and interfere with your functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.