The definition of awareness used consistently in this thesis is: Explicit recall of intraoperative events during general anaesthesia. Since there is no objective method to detect awareness, the patients must be interviewed after anaesthesia. The form and timing of the interview is crucial. To rely on spontaneous disclosure of awareness episodes is not sufficient. The total number of awareness-victims is considerable although the incidence may seem modest. A number of these patients look upon the awareness experience as the worst experience in their life. Suffering can include pain, mental distress and delayed psychological symptoms. However, the experience of awareness is not uniform and not all patients suffer.A comprehensible definition for dreaming during anaesthesia is: Any recalled experience, excluding awareness, which occurred between induction of anaesthesia and the first moment of consciousness upon emergence. Some findings point in the direction that dreaming during anaesthesia may be related to light or insufficient anaesthesia, but other findings do not. Some patients find dreaming during anaesthesia distressing, but generally the overall impression is that consequences of dreaming during anaesthesia seem to be small and of minor importance to the majority of patients.In this thesis I have found the following:The incidence of awareness is approximately 0.2% when neuromuscular blocking drugs are used and awareness also exists without these drugs, albeit to a lesser extent…
Contents
INTRODUCTION
General Anaesthesia
Memory function
Awareness
Definition
Incidence
Prevention
Consequences
Dreaming during anaesthesia
Definition
Incidence
Content and form
Consequences
AIMS
MATERIAL AND METHODS
Patients
Paper I
Paper II
Paper III
Paper IV
Interviews and classification
Paper I
Paper II
Paper III
Paper IV
Statistics
Paper I
Paper II
Paper III
Paper IV
RESULTS
Paper I
Paper II
Paper III
Paper IV
DISCUSSION
Incidence, details, and prevention of awareness
Consequences of awareness
Dreaming during anaesthesia
CONCLUSIONS
SUMMARY IN SWEDISH (SVENSK SAMMANFATTNING)
ACKNOWLEDGEMENTS
REFERENCES
Author: Samuelsson, Peter
Source: Linköping University
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