Intraoperative Anaesthesia Awareness Following Induction of Anaesthesia

University of Wisconsin, Madison260 enrolled

Overview

A primary aim of anaesthesia is to prevent awareness of surgery; ablation of the experience of surgery is the most secure way to prevent awareness with recall. Fortunately the incidence of awareness with recall (the patient can spontaneously remember the intraoperative event) is very rare (0.1-0.2%). However the investigators systematic review suggests that consciousness of intraoperative events may occur in approximately 37% of patients in experimental studies (as identified by the validated clinical procedure the isolated forearm test that does not require postoperative recall of the event). In this international cohort study, recruiting a minimum sample of 200 patients, the investigators will investigate the incidence of anaesthesia awareness (as identified by the isolated forearm test) following the induction of anaesthesia and before surgery.

Study Type

OBSERVATIONAL

Enrollment

260

Conditions

Anaesthesia

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adult patients clinically requiring intubation will be included in this cohort. * Patients must be able to follow the isolated forearm technique commands when awake and prior to their operation will be included in this cohort. Exclusion Criteria: * Contraindication to isolated forearm technique test such as unable to have tourniquet on arm for the isolated forearm technique (e.g. lymphedema or operative site).

Locations (3)

University of Michigan

Ann Arbor, Michigan, United States

University of Wisconsin

Madison, Wisconsin, United States

University of Auckland

Hamilton, Waikato Region, New Zealand

Outcomes

Primary Outcomes

Incidence of isolated forearm test responsiveness following laryngoscopy and intubation

Following induction of anaesthesia, and securing the airway (laryngoscopy and intubation) the patient will be asked to squeeze the anaesthetist's hand as a surrogate of awareness under anaesthesia.

Time frame: The test will occur within one minute of securing the airway (laryngoscopy and intubation).

Secondary Outcomes

Incidence of isolated forearm test responsiveness before laryngoscopy and intubation

Following induction of anaesthesia, and prior to securing the airway (before laryngoscopy and intubation) if safe to do so, the patient will be asked to squeeze the anaesthetist's hand as a surrogate of anaesthesia awareness.

Time frame: The test will occur in the minute prior to securing the airway (laryngoscopy and intubation).

Incidence of anaesthesia awareness with recall

After the operation and emergence from anaesthesia, and within 24 hours of the operation, the patient will be asked, using the structured Modified Brice questionnaire, about recall of intraoperative events (anaesthesia awareness).

Time frame: Within 24 hours of the operation

Patient satisfaction questionnaire

Within 24 hours of the operation and emergence from anaesthesia, the patient will be asked to complete a patient satisfaction questionnaire rating the anaesthetic care they received. This will cover the preoperative information they were given, their emergence from anaesthesia, their pain control, experience of nausea and vomiting and their general experience. They will be asked to rate their care from four options: very satisfied, satisfied, dissatisfied and very dissatisfied.

Time frame: Within 24 hours of the operation and emergence from anaesthesia