Awareness and recall in outpatient anesthesia.
We studied the incidence of awareness and explicit recall during general anesthesia in outpatients versus inpatients undergoing surgery. During a 14.5-mo period, we structurally interviewed 1500 outpatients and 2343 inpatients. Among outpatients, there were five cases of awareness and recall (one with clear intraoperative recollections and four with doubtful intraoperative recollections). Of the inpatients, six reported awareness and recall (three with clear and three with doubtful intraoperative recollections). The incidence of clear intraoperative recollections was 0.07% in outpatients and 0.13% in inpatients. The difference in the incidence was not significant. Among outpatients, those with awareness and recall were given smaller doses of sevoflurane than those without awareness and recall (P < 0.05). In conclusion, awareness and recall are rare complications of general anesthesia, and outpatients are not at increased risk for this event compared with inpatients undergoing general anesthesia.


CONCLUSIONS
Rapid recovery from general anesthesia is a crucial element of outpatient surgery. However, this practice may predispose a patient to receive less anesthetic, with increased risk for awareness and recall. We have shown that outpatients undergoing an operation using general anesthesia are not at increased risk for awareness compared with inpatients.
Wennervirta
Johanna
J
Department of Anesthesia and Intensive Care Medicine, Children's Hospital, Helsinki University Central Hospital, Stenbäckinkatu 11, FIN-00290 Helsinki, Finland. johanna.wennervirta@hus.fi
Ranta
Seppo O-V
SO
Hynynen
Markku
M
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D000777:Anesthetics / Q000008:administration & dosage / Q000009:adverse effects; D001364:Awareness / Q000502:physiology*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology*; D011446:Prospective Studies
D000777:Anesthetics