THIS NEWSLETTER IS FOR INFORMATIONAL PURPOSES ONLY. NOTHING IN THIS CONTENT CONSTITUTES MEDICAL, PSYCHOLOGICAL, OR PROFESSIONAL ADVICE. ALWAYS CONSULT A QUALIFIED HEALTHCARE PROFESSIONAL BEFORE MAKING ANY HEALTH RELATED DECISIONS.

OKAY BACK FROM THE FOLLOW UP VISIT 🩺

The 5th National Audit Project Covered Great Britain And Ireland

It Studied Accidental Awareness During General Anesthesia

Its Data Covered Both The Patient And Anesthetist Perspectives

Experiences Ranged From Sounds Or Touch Alone To Complete Awareness

75 Percent Of The Experiences Lasted Under 5 Minutes

Even So 51 Percent Of Patients Experienced Distress

41 Percent Suffered A Longer Term Adverse Effect

Distress And Harm Occurred Across The Full Range Of Experiences

They Were Particularly Likely When The Patient Experienced Paralysis

The Paralysis Could Come With Or Without Pain

A Patient's Interpretation Of Events Seemed Central To Later Impact

Explanation And Reassurance Seemed Beneficial During Suspected Cases

Both Also Appeared Beneficial At The Time Of A Report

Two Interview Studies Also Asked Patients About Lasting Effects

Twenty Six Patients Referred By Colleagues Described Their Awareness

Eighteen Patients Or 70 Percent Had Unpleasant Aftereffects

They Included Sleep Disturbances Dreams And Nightmares

Flashbacks And Anxiety During The Day Were Also Listed

The Other Interview Study Included 45 Patients

They Answered Advertisements Or Were Referred By Colleagues

All 45 Recognized The Situation As A Real Event

22 Of The 45 Had Unpleasant After Effects

11 Patients Suffered From Anxiety And Nightmares

Three Developed PTSD Syndrome And Required Medical Treatment

Next Come Three Studies That Found Very Different PTSD Rates

The First Study Investigated PTSD In People Reporting Past Awareness

Sixteen Subjects With Awareness And 10 Controls Took A PTSD Scale

Nine Of 16 Subjects Or 56.3 Percent Met Current PTSD Criteria

For Them A Mean Of 17.9 Years Had Passed Since Surgery

No Controls Met Diagnostic Criteria For Current PTSD

Aware Patients Commonly Could Not Communicate During Surgery

Helplessness Terror And Pain Were Also Common

Afterward Their Distress Related To Feeling Unable To Communicate

It Also Related To Feeling Unsafe Terrified Abandoned And Betrayed

The Second Study Followed Aware Patients From A Randomized Trial

It Used A Matched Cohort Design Aiming To Follow 13 Confirmed Patients

Six Of The 13 Confirmed Awareness Patients Had Died

Five Of The 7 Survivors Or 71 Percent Met PTSD Criteria At Interview

Three Of The 25 Controls Or 12 Percent Did Too

The Median Duration Of Symptoms Was 4.7 Years

A Third Study Came From Researchers In Sweden

98 Of 2,681 Consecutive Patients Believed They Had Once Been Aware

Deaths And Exclusions And An Assessor Review Removed The Rest

The Final Analyses Included 46 Patients

Twenty Or 43 Percent Of Them Had Experienced Pain

65 Percent Described Acute Emotional Reactions During Awareness

Fifteen Or 33 Percent Had Late Psychological Symptoms Afterward

In 6 Of Those Cases Symptoms Lasted More Than 2 Months

1 Patient Had A Diagnosis Of PTSD

Those Authors Said Recruitment Method May Affect The Result

They Found Fewer And Milder Problems Than Previous Studies Did

The American Society Of Anesthesiologists Had An Awareness Registry

Subjects Reported Explicit Recall Of Events During Anesthesia To It

They Completed A Survey And Submitted Copies Of Medical Records

68 Respondents Met The Inclusion Criteria

75 Percent Were Dissatisfied With How Their Concerns Were Addressed

Many Of Them Also Reported Long Term Harm

51 Percent Said No Anesthesia Provider Or Surgeon Voiced Concern

This 51 Percent Comes From The Registry Not The Audit

Only 10 Percent Were Offered An Apology

15 Percent Were Offered A Referral For Counseling

Preferences Included Validation Of Their Experience At 37 Percent

28 Percent Preferred An Explanation

26 Percent Wanted Discussion Or Follow Up To The Episode

The Researchers Behind The Twenty Six Patient Study Also Commented

In Their View The Anesthesiologist's Role May Be Of Great Importance

That Role Is Discussing And Dealing With Traumatic Experiences

A US Case Commentary Also Gives Advice On Responding To Patients

It Says Claims Of Awareness Should Not Be Dismissed As Imagination

In Its View Patients Usually Resent Their Team If Nobody Believes Them

The Same Happens If Staff Belittle Their Suffering While Aware

Two Things Can Help Resolve The Patient's Dissatisfaction And Anger

One Is Acknowledging The Episode Of Awareness

The Other Is Helping The Patient Come To Terms With The Experience