Psychological consequences of awareness and their treatment.
Intraoperative awareness with subsequent recall is a rare but serious complication with an incidence of 0.1-0.2%. In approximately one third of the patients who have experienced awareness, late severe psychiatric sequelae may develop. The psychiatric symptoms in these patients fulfil the diagnostic criteria for post traumatic stress disorder. To prevent awareness as a negative outcome after anaesthesia, a thorough perioperative management of anaesthesia is necessary. The definite risk for post traumatic stress disorder following awareness indicates the necessity of postoperative clinical routines to identify awareness patients. The problem must be acknowledged. Professional psychiatric assessment and follow up should constitute standard practice. The treatments of choice are Eye Movement Desensitisation Reprocessing and Cognitive Behaviour Therapy.
Lennmarken
Claes
C
Department of Anaesthesia and Intensive Care, University Hospital, S-581 85 Linköping, Sweden. claes.lennmarken@lio.se
Sydsjo
Gunilla
G
D000768:Anesthesia, General / Q000523:psychology*; D001364:Awareness / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D011939:Mental Recall / Q000187:drug effects* / Q000502:physiology; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy