BMJ 1994;309:967-968 (15 October)

Editorials

Memory of intraoperative events

Considerable public interest and anxiety exist about patients waking up during general anaesthesia with explicit memories of painful and terrifying intraoperative events. Using conventional clinical signs, anaesthetists find it almost impossible to recognise conscious awareness in patients with complete neuromuscular blockade.1 In elective surgery such awareness is often due to the anaesthetists not realising that the delivery of anaesthetic has failed. Occasionally there are fictitious claims of conscious awareness, and rarely there are cases with no obvious explanation.

Fortunately, the incidence of conscious awareness with pain during surgery is only 0.01% during elective general anaesthesia.2 The incidence has fallen considerably since the 1960s, when Hutchinson found that 0.6% of patients anaesthetised with unsupplemented nitrous oxide were awake and in pain.3 The incidence is much higher during operations for major trauma, where anaesthetic concentrations are reduced to preserve cardiovascular function.4

The psychological consequences of conscious awareness with explicit memory of pain . . . [Full text of this article]


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This article has been cited by other articles:

  • Aceto, P., Valente, A., Gorgoglione, M., Adducci, E., De Cosmo, G. (2003). Relationship between awareness and middle latency auditory evoked responses during surgical anaesthesia. Br J Anaesth 90: 630-635 [Abstract] [Full text]  
  • Griffiths, M., Thomas, T. (1994). Implicit memory. BMJ 309: 1514b-1514 [Full text]  
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