[The incidence of intraoperative conciousness in emergency surgery and its possible relation to the post-traumatic stress syndrome. Presentation of three cases].
Intraoperative awakening and recall of specific events is a rare complication (0.2 to 1.3%) of surgery. The possibility of developing serious psychiatric complications, such as posttraumatic stress disorder (PTSD) makes the prevention and detection of intraoperative awareness a subject of special interest. We describe our experience with three patients in whom awareness was detected during emergency surgery under general anesthesia. We conducted two structured interviews with the patients three months after surgery in order to detect the possible development of psychiatric complications. One patient suffered insomnia and reexperience of the event during the first two weeks after surgery. Improvement was spontaneous. None of the patients suffered PTSD. Efforts to decrease the incidence of episodes of intraoperative awakening with specific recall must be based on clinical observation and exhaustive monitoring of the patient, including anesthetic gases, given that no ideal method of monitoring depth of anesthesia exists. Cases should be detected in the first few days after surgery by means of a specific test. Likewise, possible causes for the episode should be explained to the patient, who should be followed for six months so that early diagnosis of PTSD or other psychiatric complications can be made.
Ruiz
V
V
Servicio de Anestesiología y Reanimación, Hospital Prínceps d'Espanya, Barcelona.
Koo
M
M
García
E
E
Crespo
J M
JM
Mayoral
V
V
Casals
P
P
Cochs
J
J
D000328:Adult; D000768:Anesthesia, General; D003243:Consciousness; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology*; D013514:Surgical Procedures, Operative
Incidencia de conciencia intraoperatoria en cirugía urgente y su posible relación con el síndrome de estrés postraumático. A propósito de tres casos.