Key Points
- Investigate patient experiences, psychological impact, preventability, and contributory human factors associated with accidental awareness during general anaesthesia and sedation.
- Conducted a comprehensive national audit across Great Britain and Ireland assessing reported episodes of accidental awareness during general anaesthesia and sedation.
- Evaluated patient psychological outcomes, pre-event quality of care, preventability, and medicolegal consequences through expert panel review.
- Although 75% of awareness episodes lasted < 5 min, 51% (95% CI 43–60%) of patients experienced distress and 41% (95% CI 33–50%) suffered long-term adverse psychological effects, particularly when paralysis occurred.
- Quality of care before the event was judged good in 26%, poor in 39%, and mixed in 31%, with 75% of all awareness cases deemed preventable.
- Accidental awareness occurred in approximately 1:19,000 general anaesthetics and 1:15,000 sedation procedures; 6% of patients pursued legal action and 11% lodged formal complaints.
Structured PICO
PPopulationPatients experiencing accidental awareness during general anaesthesia or sedation in Great Britain and Ireland.
OOutcomePatient experiences, distress, and longer-term adverse effects of accidental awareness during general anaesthesia.patient reported
Accidental awareness during general anaesthesia, though often brief, causes significant distress and long-term harm in a large proportion of patients, and the majority of cases are considered preventable.