Anesthesia awareness is a rare, but severe complication of anesthesia with possible severe long-term effects that is more commonly reported after trauma and emergent surgery. Anesthesia awareness in trauma patients who require emergency surgery has not been researched on since Bogetz and Katz’s study in 1984. This landmark study reported a higher risk of anesthesia awareness due to multiple factors, including intolerance of anesthetic agents in these patients who often present with hemodynamic instability and low blood pressure. Given the reported risk of awareness in this population, clinicians continue to administer standard doses of anesthetic agents despite the associated hemodynamic effects and the concern for other anesthesia-related complications. Therefore, it is important to determine if the risk factors and incidence of awareness remains high despite recent advances in anesthetic techniques and monitoring. We hypothesized that awareness under general anesthesia in trauma patients is less common with the use of modern-day anesthetic agents and monitoring devices. To examine this hypothesis, the incidence of anesthesia awareness was retrospectively studied in all trauma patients requiring emergency surgery at Boston Medical Center (BMC) between January 2020 and February 2022. The patients were asked a 5-minute questionnaire which included questions from the modified Brice questionnaire to determine the incidence of perioperative awareness. It was found that the incidence of awareness during general anesthesia in trauma surgery patients at BMC from January 2020 through February 2022 was significantly lower (with an incidence of 0%) than the previously reported incidence of 11% by Bogetz and Katz, (p = 0.028, CI -0.22-0.00). Further research is warranted to confirm our findings and further explore the incidence and impact of awareness in this vulnerable population. Future prospective studies should examine a greater number of trauma patients, associated risk factors, and the role of processed EEG monitoring in preventing awareness during general anesthesia.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48387 |
| Date | 11 March 2024 |
| Creators | Tashjian, Kayla Talar |
| Contributors | Canelli, Robert, Nozari, Ala |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
Page generated in 0.0022 seconds