title: Awareness during surgery.
abstract: OBJECTIVE
  Patients who experience awareness under surgery may suffer from the post-traumatic stress disorder with its long-lasting psychological damage. Furthermore, there are also media attention and legal consequences. In spite of understanding its causes, it is still occurring worldwide and there are no reports of awareness in the Saudi medical literature. This prospective study was conducted to determine the incidence of awareness when its causes are eliminated and to record patient satisfaction.
  
  
  METHODS
  Surgical patients >4 years old (ASA I-III) admitted to the Armed Forces Hospital, Wadi Al-Dawasir, Kingdom of Saudi Arabia, between October 1998 and November 2002 were included in the study. Patients were given a premedicant with an amnesic effect. Anesthetic equipment with a built-in end-tidal anesthetic gas monitor was checked preoperatively. Minimal anesthetic concentrations of vapors were delivered and monitored. Intraoperative analgesia was provided whenever appropriate. Patients were closely observed for signs of intraoperative awareness under general anesthesia. All patients were interviewed within 24 hours postoperatively on the occurrence of awareness and service satisfaction.
  
  
  RESULTS
  There were 4368 patients admitted to the study. Their ages ranged from 14-104 years (mean 40.2 years). All patients were interviewed in the postoperative period. There was no report of awareness during surgery and patient satisfaction score was 100%.
  
  
  CONCLUSIONS
  Preoperative and intraoperative anesthetic attention to patients presented for surgery, together with the use of modern anesthetic delivery units possessing facilities for monitoring anesthetic gases, and the provision of good analgesia are the most important combination in eliminating awareness during surgery.
authors.affiliation: Department of Anesthesia and Intensive Care, Armed Forces Hospital, PO Box 228, Wadi Al-Dawasir 11991, Kingdom of Saudi Arabia. fmamessahel@doctors.org.uk
authors.forename: Farouk M
authors.initials: FM
authors.lastname: Messahel
authors.forename: Ali S
authors.initials: AS
authors.lastname: Al-Qahtani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000523:psychology*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000523:psychology*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D011300:Preoperative Care; D011446:Prospective Studies; D012529:Saudi Arabia; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology; D011795:Surveys and Questionnaires