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Accidental Awareness High With General Anesthesia in Obstetric Surgeries

FRIDAY, Jan. 22, 2021 -- The incidence of accidental awareness is high among women receiving general anesthesia for obstetric surgery, according to a study published online Jan. 12 in Anaesthesia.

Peter M. Odor, B.M., B.Sc., from the University College London Hospital, and colleagues examined the incidence, experience, and psychological implications of unintended conscious awareness during general anesthesia among 3,115 consenting patients receiving general anesthesia for obstetric surgery in 72 hospitals in England from May 2017 to August 2018.

The researchers found that 12 patients had certain/probable or possible awareness, with an incidence of one in 256 for all obstetric surgery and one in 212 for cesarean section surgery. Seven, five, and two patients (58.3, 41.7, and 16.7 percent, respectively) reported distressing experiences, paralysis, and paralysis with pain, respectively. In nine of the patients who reported awareness, accidental awareness occurred during induction and emergence. High body mass index (BMI), low BMI, out-of-hours surgery, and use of ketamine or thiopental for induction were factors associated with accidental awareness. Compared with patients without awareness, those with awareness had significantly higher standardized psychological impact scores at 30 days (median, 15 versus 3). A provisional diagnosis of posttraumatic stress disorder was reported by four patients.

"Although we have provided many answers, questions remain as to exactly why awareness is more common in pregnant women; our next steps are to apply the lessons learned from this study to help reduce risk in the future," Odor said in a statement.

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