Key result
Among 2000 perioperative anesthetic adverse event incidents, 9 episodes (0.45%) of intraoperative awareness were observed, with anesthesia-related factors contributing to all cases.
Why the study?
Despite improvements in anesthetic-related modalities, unintended intraoperative awareness still occurs, prompting an evaluation of incidents occurring across Thailand.
Observational (n=2,000)
Yes
Intraoperative awareness is a rare but preventable adverse event, with anesthetic components and provider experience being the most influential factors for prevention.
Should not yet change practice; leaves open whether quality assurance targeting anesthesia factors reduces intraoperative awareness.
BACKGROUND: Despite the improvement of anesthetic-related modalities, the incidence of unintended intraoperative awareness remains at around 0.005-0.038%. OBJECTIVE: We aimed to describe the intraoperative awareness incidents that occurred across Thailand between January to December, 2015. METHODS: Observational data was collected from 22 hospitals throughout Thailand. The awareness category was selected from incident reports according to the Perioperative Anesthetic Adverse Events in Thailand (PAAd Thai) study database and descriptive statistics were analyzed. The awareness characteristics and the related factors were recorded. RESULTS: A total of nine intraoperative awareness episodes from 2000 incidents were observed. The intraoperative awareness results were as follows: experience of pain (38.1%), perception of sound (33.3%), perception of intubation (9.5%) and feeling of paralysis (14.3%). The observed factors that affect intraoperative awareness were anesthesia-related (100%), patient-related (55.5%), surgery-related (22.2%) and systematic process-related (22.2%). The contributing factors were situational inexperience (77.8%) and inappropriate patient evaluation (44.4%). An awareness of anesthetic performer (100%) and experience (88.9%) were defined as incident-mitigating factors. The suggested corrective strategies were quality assurance activity (88.9%), improved supervision (44.4%) and equipment utilization (33.3%), respectively. CONCLUSION: Nine intraoperative awareness incidents were observed, however the causes were preventable. The anesthetic component seems to be the most influential to prevent these events.
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Akavipat et al. (2020) conducted an observational in Perioperative Anesthetic Adverse Events (n=2,000). Perioperative anesthesia was evaluated on Intraoperative awareness episodes. Among 2000 perioperative anesthetic adverse event incidents, 9 episodes (0.45%) of intraoperative awareness were observed, with anesthesia-related factors contributing to all cases.
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