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Topic: Anesthesia awareness

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	Anesthesia awareness - Wikipedia, the free encyclopedia
		Anesthesia awareness, or "intra-operative awareness" occurs during general anesthesia, when a patient is paralyzed with muscle relaxants but not enough general anesthetic or analgesic to prevent consciousness or, more importantly, the sensation of pain and the recall of events.
		The experience may be traumatizing for the patient who is unable to communicate his or her distress due to the muscle relaxants.
		The prevalence of anesthesia awareness in the United States is believed to be 20,000 to 40,000 cases per year, which represents 0.1 percent and 0.2 percent of all patients undergoing general anesthesia (JCAHO 2004).
	en.wikipedia.org /wiki/Anesthesia_awareness (1176 words)

	Anesthesia - Wikipedia, the free encyclopedia
		Anesthesia (American English), also anaesthesia (British English), is the process of blocking the perception of pain and other sensations.
		Dioscorides for example reports of in anesthesia from an accredited program and are supervised directly by an anesthesiologist.
		In modern anesthesia, a wide variety of medical equipment is desirable depending on the necessity for portable field use, surgical operations or intensive care support.
	en.wikipedia.org /wiki/Anesthesia (1670 words)

	Anesthesia awareness definition - Medical Dictionary definitions of popular medical terms
		Anesthesia awareness: The situation that occurs when a patient under general anesthesia becomes aware of some or all events during surgery or a procedure, and has direct recall of those events.
		The incidence of awareness is reported to be greater in patients in which the dose of general anesthetic must be smaller and carefully titrated to decrease significant side effects, for example, a patient who is hemodynamically unstable.
		Factors contributing to the risk of anesthesia awareness include the increasing use of intravenous (IV) delivery of anesthesia, as opposed to inhalation anesthesia, and the premature lightening of anesthesia at the end of procedures to facilitate turnover of the operating room.
	www.medterms.com /script/main/art.asp?articlekey=40143 (606 words)

	Anesthesia Awareness Alert - National Anesthesia Service
		Anesthesia awareness, also called unintended intraoperative awareness, occurs under general anesthesia when a patient becomes cognizant of some or all events during surgery or a procedure, and has direct recall of those events.
		The frequency of anesthesia awareness has been found in multiple studies to range between 0.1 percent and 0.2 percent of all patients undergoing general anesthesia.(1,2,3) The administration of general anesthesia to 21 million patients annually in the United States translates to the occurrence of 20,000 to 40,000 cases of anesthesia awareness each year.
		To overcome the limitations of current methods to detect anesthesia awareness, new methods are being developed that are less affected by the drugs typically used during general anesthesia.
	www.anesthesia.med.va.gov /anesthesia/page.cfm?pg=55 (1176 words)

	Joint Commission Resources : Strategies for Combating Anesthesia Awareness (Site not responding. Last check: 2007-10-08)
		While general anesthesia is an extremely safe process that allows surgeons to perform complex and necessary procedures, it is estimated that between 0.1% and 0.2% of all patients undergoing general anesthesia experience some form of anesthesia awareness.(1) This translates into an average of 30,000 cases per year.
		The likelihood of experiencing anesthesia awareness increases among cardiac surgery, obstetric, and severe trauma patients as the level of anesthesia used in these cases is less than other types of surgery and might not be sufficiently deep to prevent awareness.
		Other causes of anesthesia awareness include the misuse or failure of anesthesia equipment, lack of vigilance on the part of the anesthesiologist, or an intentional lightening of anesthetic to facilitate a quicker recovery and improve operating room turnover.
	www.jcrinc.com /publications.asp?durki=9260&site=4&return=9258 (1958 words)

	Carol Weihrer - Wikipedia, the free encyclopedia
		Carol Weihrer (born ~1951) is an activist for victims of anesthesia awareness.
		Weihrer's website, Anesthesia Awareness, reports that the information contained within it represents only her experiences, views, research, and knowledge.
		It maintains that she is the President and Founder of The Anesthesia Awareness Campaign, Inc. whose costs "are being borne totally by [her] own personal commitment of time, money, energy, and outreach and research; along with a few monetary gifts."
	en.wikipedia.org /wiki/Carol_Weihrer (211 words)

	AORN ONLINE: Journal: January 2005: Clinical Issues (Site not responding. Last check: 2007-10-08)
		Anesthesia awareness is the postoperative recollection of noises; conversation; pain; feelings, such as those experienced during the intubation process or by cold instruments being inserted into the surgical site; or other events that occurred during the time the patient was under anesthesia.
		If a history of awareness is discovered, the preoperative nurse should notify the anesthesia care provider and all other perioperative team members immediately of the potential risk for anesthesia awareness.
		A facility representative, such as the anesthesia care provider, risk manager, nursing staff member, or other designated professional, should follow up with the patient daily during the period of hospitalization and for a period of time after the patient is discharged.
	www.aorn.org /journal/2005/janci.htm (2340 words)

	Anesthesia - LearnThis.Info Enclyclopedia (Site not responding. Last check: 2007-10-08)
		Doctors specialising in the administration of anesthetics are known as anesthesiologists (AE) or anaesthetists (BE).
		However, when either technique is possible, regional anesthesia is about 30% safer than general anesthesia.
		Neuraxial blockade reduces the risk of deep vein thrombosis, pulmonary embolism, transfusion, pneumonia, respiratory depression, myocardial infarction and renal failure[1].
	encyclopedia.learnthis.info /a/an/anesthesia.html (794 words)

	ABC News: 'Anesthesia Awareness': When Patients Wake Up During Surgery (Site not responding. Last check: 2007-10-08)
		Weihrer experienced "anesthesia awareness" — or what doctors call "awareness with recall" — when patients aren't fully anesthetized and are aware they're being operated on.
		She and others say the solution is relatively simple: besides making patients aware of the potential risk, hospitals should install monitoring technology that can alert anesthesiologists if a patient is on the verge of waking up.
		Awareness is more likely during cardiac surgeries, traumas and emergency C-sections, Litwiller explained, because "it isn't safe for the patient or the baby to have the deepest level of anesthesia."
	abcnews.go.com /Health/Healthology/story?id=205890 (854 words)

	Nursing Spectrum- Career Fitness Online - verbal abuse
		Supposedly unaware, under general anesthesia, Weihrer says she was as awake and alert during the 5.5-hour procedure as she was during the interview for this story.
		Anesthesia awareness, according to McKibban, occurs under general anesthesia, when patients become aware of and can recall something happening in the operating room during surgery or a procedure.
		Patients who experienced awareness with past surgeries and those who have taken high doses of sedatives or barbiturates before surgery or beta blockers or calcium channel blockers are also at elevated risk of awareness.
	nsweb.nursingspectrum.com /cfforms/GuestLecture/UnderButAware.cfm (1324 words)

	Patient Awareness
		Awareness can range from brief, hazy recollections to some specific awareness of your surroundings during surgery.
		Awareness can occur in high-risk surgeries such as trauma and cardiac surgery in which the patient’s condition may not allow for a deep anesthetic to be given.
		Patients should talk with their anesthesia professional before surgery to discuss all of their concerns, including the remote possibility of awareness.
	www.asahq.org /news/topten.htm (395 words)

	washingtonpost.com: Wake-Up Call
		Every year an estimated 20,000 to 40,000 of the 21 million patients who receive general anesthesia wake up during surgery because they are under-anesthetized, usually by mistake or because doctors fear too high a dose of anesthesia could be dangerous.
		Other cases occur when anesthesia is lightened too early at the end of a case "to facilitate operating room turnover," according to JCAHO, or when an intentionally light dose is given to a cardiac or trauma patient for fear that too much anesthetic could be dangerous, even fatal.
		General anesthesia typically consists of three kinds of drugs: a paralytic to prevent movement; a hypnotic gas or intravenous drug that renders the patient unconscious and unable to remember what happened or to feel pain signals; and a painkiller.
	www.washingtonpost.com /ac2/wp-dyn/A4207-2004Nov22?language=printer (2687 words)

	Anesthesia Patient Safety
		As a result of her experience, Liska is dedicated to patient and healthcare provider education in the area of anesthetic awareness, with an emphasis on therapy and research.
		She holds a doctorate in divinity and a doctorate in pastoral psychology, and is the founder and president of AWARE (Awareness With Anesthesia Research Education).
		The council is a multidisciplinary body with public representation that is concerned with issues involving public safety in anesthesia care, and acts as an autonomous appellate body in the credentialing of nurse anesthetists and their educational programs.
	www.anesthesiapatientsafety.com /patients/ss/silenced_screams.asp (466 words)

	anesthesiaawareness.com
		Anesthesia Awareness is probably the most helpless and terrifying feeling in the world.
		Anesthesia Awareness has been one of the best-kept secrets in anesthesia, and was, at one time, one of the least-known phenomena in the medical or legal fields in general.
		But there are still many doctors I have talked to who are amazed awareness occurs, and are unaware of the extent of the problem, the tremendous post-operative effects on mind and body, or the attitude of the professionals in the anesthesia field.
	www.anesthesiaawareness.com /index2.ivnu (1394 words)

	JCAHO issues sentinel alert over inadequate anesthesia - Drug Topics
		Anesthesia awareness—the unexpected cognizance that occurs when anesthesia lightens during surgery—is the subject of a recent Sentinel Event Alert issued by the Joint Commission on Accreditation of Healthcare Organizations.
		Forty-eight percent of patients who experience awareness report auditory recollections, 48% report being unable to breathe, and 28% report pain—without being able to communicate this to the surgical team.
		While effective anesthesia monitoring would seem an ideal solution to prevent anesthesia awareness, appropriate techniques are still in their infancy.
	www.drugtopics.com /drugtopics/article/articleDetail.jsp?id=133840 (600 words)

	Infection Control Today - Study Documents U.S. Incidence of Intraoperative Awareness
		The study, known as the AIM trial, evaluated 19,576 patients and documented that awareness with recall occurs in the U.S. at a rate between one to two cases per 1,000 patients receiving general anesthesia.
		Results also documented an additional 46 reports of possible awareness where investigators were not able to obtain sufficient data to confirm awareness, and 1,182 (6 percent) reports of intraoperative dreaming.
		As part of this commitment, awareness experts from around the world have collaborated to define the scope of the problem of awareness and to determine the impact of additional monitoring on patient outcomes," said Paul Manberg, PhD, vice president of clinical, regulatory and quality assurance for Aspect.
	www.infectioncontroltoday.com /hotnews/48h30112134.html (818 words)

	New Home
		Anesthesia awareness is the phenomenon of being mentally alert (and terrified) while supposedly under full general anesthesia.
		What needs to be changed is the attitude about the possibility of awareness occurring in the future with any patient or in the belief that a patient really was awake — and even more unrecognized is the extent and extremity of the devastating sequelae on victims.
		Awareness through personally speaking by phone with over 2600 victims of awareness and continuing to do so on a daily basis.
	www.anesthesiaawareness.com (526 words)

	AAOS Online Bulletin (Site not responding. Last check: 2007-10-08)
		The phenomenon of anesthesia awareness, also called unintended intraoperative awareness, occurs under anesthesia when a patient becomes cognizant of some or all events during a surgical procedure and has direct recall of those events.
		Because of the routine use of paralytics during general anesthesia, the patient is often unable to communicate with the surgical team if this occurs.
		As a consequence, health care practitioners must be prepared to acknowledge and manage the occurrence of anesthesia awareness with compassion and diligence.
	www.aaos.org /wordhtml/bulletin/Dec04/fline2.htm (337 words)

	Anes514
		In a phone study of 1216 Canadians regarding attitudes toward general anesthesia, the majority felt it was important to talk to the anesthesiologist the day before surgery.
		Nine consecutive patients who had experienced anesthesia awareness, and who had been given information and repeated discussion postop until the patients felt that they were satisfied and did not need further contact, were contacted two years later.
		Survey of Australian women who had experienced anesthesia awareness (1950s to early 1990s); graphic descriptions and wide range of symptomatology, but almost universal lack of understanding or helpful management by medical personnel (patients were disbelieved, ignored, scoffed at or laughed at).
	womensmindbodyhealth.info /anes514.htm (894 words)

	USNews.com: Health: In Brief: Public Health: Anesthesia awareness: Brain monitors get a 'tepid ' endorsement
		Among them: cardiac patients under light anesthesia to keep the heart from being stressed; trauma patients for the same reason; emergency cesarean patients whose anesthesia has to be minimized to protect the baby—and patients who express concern about awareness.
		But because the probability of awareness is deemed so low, a huge number of patients would have to be enrolled—"some 750,000," says Guidry.
		But it's just a baby step." Weihrer, who after her experience created a Web-based effort called Anesthesia Awareness Campaign, wants to see ASA emphasize to its members the need to ask all anesthesia patients whether they awakened during surgery, to investigate all such reports, and to provide psychological counseling when necessary.
	www.usnews.com /usnews/health/briefs/publichealth/hb051026a.htm (789 words)

	Intra-Operative Awareness (IOA)
		Fortunately, this terrifying ordeal can often be avoided when patients are informed about anesthesia dangers and then make a point of communicating their concerns to doctors and anesthesiologists.
		According to her anesthesia awareness web site, many doctors are unfamiliar with the long-range problems associated with IOA.
		Some anesthesia procedures leave the patient paralyzed during the operation, making it impossible to communicate anesthesia awareness.
	www.anapsid.org /cnd/drugs/anesthesia2.html (600 words)

	Aspect Medical Systems \| Healthcare Professionals
		This study established that awareness with recall occurs in the U.S. at a rate of 1-2 cases per 1,000 patients receiving general anesthesia.
		Patients were randomly assigned to receive either standard general anesthesia, or general anesthesia with BIS monitoring.
		In this study, routine use of BIS monitoring reduced the incidence of awareness in the general patient population by 77% compared to historical control.
	www.aspectmedical.com /professionals/safety/default.mspx (295 words)

	Closed Claims: Awareness during anesthesia (Site not responding. Last check: 2007-10-08)
		Background: Awareness during general anesthesia is a frightening experience, which may result in serious emotional injury and post-traumatic stress disorder.
		All claims for intraoperative awareness were reviewed by the reviewers to identify patterns of causation and standard of care.
		Results: Awareness claims accounted for 79 (1.9%) of 4,183 claims in the database, including 18 claims for awake paralysis, i.e., the inadvertent paralysis of an awake patient, and 61 claims for recall during general anesthesia, i.e., recall of events while receiving general anesthesia.
	depts.washington.edu /asaccp/ASA/Abstracts/Anesth90_1053_1061.shtml (364 words)

	ASHP News: 'Anesthesia Awareness' Receives Renewed Attention
		) about anesthesia awareness, the term sometimes used to describe the phenomenon in which patients who receive general anesthesia and a paralyzant are later partially awake but unable to communicate with the health care professionals standing nearby.
		For the prevention of anesthesia awareness, the alert cites recommendations from the February 2000 issue of Anesthesiology, which suggests such actions as:
		Release of the alert, which also covers management of the problem, came one month after publication in Anesthesia and Analgesia of a study that estimated the rate of anesthesia awareness in the United States at 0.13 percent.
	www.ashp.org /news/ShowArticle.cfm?id=8074 (306 words)

	[No title] (Site not responding. Last check: 2007-10-08)
		One of the more controversial aspects of anesthesia awareness is the use of electroencephalography or level-of-consciousness monitoring equipment.
		For instance, awareness may occur more often with intravenous medications while a patient is on a heart-lung machine.
		Much of the anesthesia administered now is given in outpatient settings, so nurses in ambulatory care centers and physician’s offices also must be aware that this phenomenon occurs and how to help patients.
	www.amnhealthcare.com /FeatureTopics.asp?ArticleID=13026 (854 words)

	Waking During Surgery: A Real, Terrifying Nightmare -- ThirdAge
		Such anesthesia awareness is not as rare as one might think.
		General anesthesia is a combination of several drugs that block pain, paralyze the muscles so surgeons can cut tissue more easily and render patients unconscious and unable to remember the operation.
		But often, anesthesia awareness is a genuine mistake that, until the last few years, doctors had no good way to detect -- though increases in heart rate and blood pressure, or leaking of tears from the eyes, are clues.
	www.thirdage.com /news/articles/ALT02/05/04/15/ALT02050415-02.html (954 words)

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