Intraoperative awareness: detected by the structured Brice interview?

Abstract:

BACKGROUND:Awareness is a rare complication in general anesthesia, but its consequences are stressful. Efforts must be undertaken to prevent, diagnose, and, if occurring, treat it. The incidence of awareness is higher following anesthesia involving the use of muscle relaxants. As a part of a quality assurance program at our short-stay surgery all patients exposed to general anesthesia are routinely subjected to a Brice interview, which aims to evaluate our standard anesthetic technique regarding awareness. METHODS:The Brice interview was used prospectively in 5216 patients given a propofol/opioid anesthetic for day-case or short-stay surgery. Neuromuscular blocks were used only for surgical needs, not routinely. All patients were interviewed on discharge from the recovery room. A second interview, according to Brice, was undertaken by telephone 3-7 days later in the case of a notable intraoperative event, or otherwise after postoperative patient complaints. All patients were also interviewed by telephone 1-2 days postoperatively. RESULTS:None of the patient interviews indicated awareness. This was also the case in five non-relaxed patients who had an incident of light anesthesia with eye opening and gross motor response without forewarning. Neuromuscular blockade was used in 7% of patients. DISCUSSION:We were unable to detect intraoperative awareness. The anesthetic regimen, including minimal use of muscle relaxants, might be beneficial for awareness prevention. Alternatively, the diagnostic power, the timing of the Brice interview, or the number of interviews performed may be questioned.

authors

Enlund M,Hassan HG

doi

10.1034/j.1399-6576.2002.460402.x

subject

Has Abstract

pub_date

2002-04-01 00:00:00

pages

345-9

issue

4

eissn

0001-5172

issn

1399-6576

pii

aas460402

journal_volume

46

pub_type

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