Page 67 - 2022 Risk Basics - Anesthesiology

SVMIC Risk Basics: Anesthesiology

pressure or pain following their procedure. Anesthetic

awareness is not the same as remembering some of the
events surrounding the procedure such as preoperative and

postoperative activities, nor is it “dreaming” during the

procedure, both of which are normal.

Most patients who have experienced true anesthetic

awareness have brief, vague recollections of the events; but

depending on the person and the type of procedure, anesthetic
awareness can be disturbing and even traumatic, especially if

pain is experienced. It is the patient who suffers this type of

awareness who typically asserts a malpractice claim against
the anesthesia provider.

The causes of anesthetic awareness can vary. Common

causes include inadequate anesthesia and equipment
failure/misuse. It also occurs more frequently in patients with

multiple medical conditions and certain procedures such as
emergency C-sections, heart surgeries, and

emergency/traumatic injury surgeries most likely because the
usual dose of required anesthesia cannot be used safely.

Patients are also more likely to experience awareness with

procedures that use local anesthesia or intravenous (“twilight”)
sedation rather than general anesthesia such as

colonoscopies. The incidence of awareness doubles with the

use of a paralytic agent. Finally, patients who have a history
27
of excessive alcohol and drug use are at increased risk.

27 Sandin RH et al: Awareness during anesthesia: a prospective case study. Lancet 2000Feb
26;355(9205):707-11

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