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The largest ever study of awareness during obstetric general anaesthesia shows around 1 in 250 women may be affected, and some may experience long-term psychological harm.

ECG monitor screen

Accidental awareness occurs when a patient is temporarily conscious during a general anaesthetic and can remember things that happened during surgery, perhaps feeling pain or being unable to move. More commonly however, awareness occurs during the transition at the very start or end of a general anaesthetic (i.e. before and after surgery), as the patient is going to sleep or waking up. Although accidental awareness during general anaesthesia is rare, and the experiences usually only lasted for a few seconds or minutes, the complication remains an important concern for both patients and anaesthetists.

A new study co-authored by Professor Jaideep Pandit and published in Anaesthesia, shows that 1 in 256 women undergoing pregnancy-related surgery, including caesarean section, under general anaesthesia experienced awareness – a figure much higher than reported before. A recent national audit into accidental awareness (NAP5 - of which Professor Pandit is the lead author) indicated that approximately 1 in every 19,000 patients undergoing general anaesthesia spontaneously reported accidental awareness to medical staff. Although this incidence varied for different types of surgery and patient subgroups, the infrequency of reports was reassuring.

The full story is available on the Nuffield Department of Clinical Neurosciences website

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