title: Patient perspectives on intraoperative awareness with explicit recall: report from a North American anaesthesia awareness registry.
abstract: BACKGROUND
  Awareness during general anaesthesia is a source of concern for patients and anaesthetists, with potential for psychological and medicolegal sequelae. We used a registry to evaluate unintended awareness from the patient's perspective with an emphasis on their experiences and healthcare provider responses.
  
  
  METHODS
  English-speaking subjects self-reported explicit recall of events during anaesthesia to the Anesthesia Awareness Registry of the ASA, completed a survey, and submitted copies of medical records. Anaesthesia awareness was defined as explicit recall of events during induction or maintenance of general anaesthesia. Patient experiences, satisfaction, and desired practitioner responses to explicit recall were based on survey responses.
  
  
  RESULTS
  Most of the 68 respondents meeting inclusion criteria (75%) were dissatisfied with the manner in which their concerns were addressed by their healthcare providers, and many reported long-term harm. Half (51%) of respondents reported that neither the anaesthesia provider nor surgeon expressed concern about their experience. Few were offered an apology (10%) or referral for counseling (15%). Patient preferences for responses after an awareness episode included validation of their experience (37%), an explanation (28%), and discussion or follow-up to the episode (26%).
  
  
  CONCLUSIONS
  Data from this registry confirm the serious impact of anaesthesia awareness for some patients, and suggest that patients need more systematic responses and follow-up by healthcare providers.
authors.affiliation: Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: C D
authors.initials: CD
authors.lastname: Kent
authors.affiliation: Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Posner
authors.affiliation: Departments of Anesthesiology and Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
authors.forename: G A
authors.initials: GA
authors.lastname: Mashour
authors.affiliation: Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: S L
authors.initials: SL
authors.lastname: Mincer
authors.affiliation: Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA Present Address: Clinical Research Manager, Kypha Inc., St. Louis, MO, USA.
authors.forename: R R
authors.initials: RR
authors.lastname: Bruchas
authors.affiliation: Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: A E
authors.initials: AE
authors.lastname: Harvey
authors.affiliation: Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA kdomino@uw.edu.
authors.forename: K B
authors.initials: KB
authors.lastname: Domino
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D058926:Intraoperative Awareness / Q000453:epidemiology*; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D012042:Registries
keywords: anaesthesia, general; intraoperative awareness; patient preference; patient satisfaction; registries