title: [Waking up during general anaesthesia].
abstract: Awareness with recall is defined as 'both conscious experience and memory of events during surgery'. Perceptions of sound, pain or paralysis and assimilation of these in the memory can lead to post-traumatic stress disorder. Prospective studies report an incidence of 0.1-1%. Risk factors include those circumstances that result in under-dosing of anaesthetic agents relative to the patient's specific requirement. A lack of reliable monitoring of depth of anaesthesia is a result of our limited knowledge of the effect of anaesthetics on consciousness and memory. No additional benefit has been shown for the use of bispectral index (BIS) monitoring compared with measuring the expired concentration of an inhaled anaesthetic agent. High-risk patients undergoing total intravenous anaesthesia may benefit from BIS for monitoring depth of anaesthesia. Further scientific investigation of the neurological processes involved in awareness with recall is required in order to develop novel monitoring techniques.
authors.affiliation: Universitair Medisch Centrum Utrecht, afd. Anesthesiologie, Utrecht.
authors.forename: Ronald D L
authors.initials: RD
authors.lastname: Akkerman
authors.forename: Johannes T A
authors.initials: JT
authors.lastname: Knape
mesh_terms: D000768:Anesthesia, General / Q000009:adverse effects / Q000379:methods*; D001364:Awareness; D056805:Consciousness Monitors / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D058926:Intraoperative Awareness / Q000517:prevention & control / Q000523:psychology; D007431:Intraoperative Complications / Q000523:psychology; D008297:Male; D008568:Memory; D008991:Monitoring, Physiologic / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology