Awareness with Recall During General Anesthesia: A Cross-Sectional Study

Abstract

Background: Accidental awareness and recall a well-known complication of anesthesia and sedation despite advancements in monitoring, drugs, and techniques. This study aimed to determine the prevalence and factors of awareness with recall (AWR) during general anesthesia in a tertiary care hospital. Methods: A cross-sectional study was conducted at Maqsood Medical Center Peshawar from April to October 2022, with a total of 383 patients ≥18 years, in good neurological health, and having ASA Physical Status I, II, III, IV undergoing elective general anesthesia-based procedures were included through a convenience sampling technique. Data was collected by administering the Brice questionnaire for structured interviews one hour after admission in PACU after assessing responsiveness. Data was analyzed using SPSS 26 with p<0.05 considered significant. Results: The mean age of the study participants was 40.93+05.2 years. The Incidence of awareness was found 7(1.8%) out of which 8(2.1%) experienced pain, 7(1.8%), being touched, 7(1.8%), hearing sounds, 8(2.1%), unable to speak 8(2.1%), feeling of paralysis, 6(1.6%) experienced tube being inside the throat, 17(4.4%) experienced an abrupt increase in blood pressure, 7(1.8%) experienced sweating, and tear production and 5(1.3%) observed movement and grimacing. No specific association was found between awareness of gender and surgery type. There was a significant association between awareness and ASA classification(p=0.000) and with intraoperative pain(p=0.00), and hemodynamic changes (p=0.04). Conclusion: In conclusion, there was an unexpectedly high prevalence of anesthetic awareness with recall. During surgery, patients typically experience pain, difficulty in communication, and paralysis. Keywords: Analgesia, Anesthesia, Operative Surgical Procedure, Metacognition.

Keywords

• Anaesthesia, general anaesthesia, awareness monitoring, depth of anaesthesia