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Biosci Trends. 2019;13(4):364-366. doi: 10.5582/bst.2019.01237.

Accidental awareness while under general anaesthesia.

Chang L1,2, Luo Q2,3, Chai Y4, Shu H1,2.

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Department of Anesthesiology, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine.
Department of Anesthesiology, Guangdong Second Provincial General Hospital.
The Second School of Clinical Medicine, Southern Medical University.
Department of Anesthesiology, Cardiovascular Institute of Guangdong Province, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences.


Accidental awareness during general anaesthesia may cause many intraoperative discomforts and bring further moderate to severe long-term symptoms including flashbacks, nightmares, hyperarousal or post-traumatic stress disorder. The incidence of awareness varied from 0.017% to 4% among studies. The relatively reliable incidence of intraoperative awareness with postoperative recall is 0.02%. The reason causing awareness was unclear. Insufficient anaesthetic dosing was thought as the principal cause. Even awareness was not comprehensively understood, some endeavors have been raised to prevent or reduce it, including i) Reducing the insufficient anaesthetic dosing induced by negligence; ii) Providing close clinical observation and clinical parameters from the monitor such as bispectral index or electroencephalogram, as well as isolated forearm technique and passive brain-computer interface may bring some effects sometimes. Because current studies still have some flaws, further trials with new detecting approach, superior methodology and underlying aetiology are needed to unfasten the possible factors causing awareness.


Accidental awareness; general anaesthesia

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