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Anesthesia Awareness: Narrative Review of Psychological Sequelae, Treatment, and Incidence

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Abstract

Awareness during general anesthesia occurs when patients recall events or sensations during their surgeries, although the patients should have been unconscious at the time. Anesthesiologists are cognizant of this phenomenon, but few discussions occur outside the discipline. This narrative review summarizes the patient recollections, psychological sequelae, treatment and follow-up of psychological consequences, as well as incidence and etiology of awareness during general anesthesia. Recalled memories include noises, conversations, images, mental processes, feelings of pain and/or paralysis. Psychological consequences include anxiety, flashbacks, and posttraumatic stress disorder diagnosis. Limited discussion for therapeutic treatment after an anesthesia awareness experience exists. The incidence of anesthesia awareness ranges from 0.1 to 0.2% (e.g., 1–2/1000 patients). Increased recognition of awareness during general anesthesia within the psychological/counseling community, with additional research focusing on optimal therapeutic treatment, will improve the care of these patients.

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Acknowledgments

The authors thank Karen L. Posner, PhD for editorial assistance and Lynn Akerlund for secretarial assistance.

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  1. Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA

    Robin R. Bruchas, Christopher D. Kent, Hilary D. Wilson & Karen B. Domino

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  1. Robin R. Bruchas
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  2. Christopher D. Kent
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Correspondence to Karen B. Domino.

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Supported in part by the American Society of Anesthesiologists (ASA), Park Ridge, Illinois. All opinions expressed are those of the authors and do not reflect the policy of the ASA.

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Bruchas, R.R., Kent, C.D., Wilson, H.D. et al. Anesthesia Awareness: Narrative Review of Psychological Sequelae, Treatment, and Incidence. J Clin Psychol Med Settings 18, 257–267 (2011). https://doi.org/10.1007/s10880-011-9233-8

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