A Case Report of Intraoperative Awareness under General Endotracheal Anesthesia during Decompressive Laminectomy T3–T4

A BSTRACT Intraoperative awareness during general anesthesia remains a significant concern. This report presents a rare case of a 40-year-old male patient, experiencing intraoperative awareness during an elective decompressive laminectomy T3–T4 for spinal cord compression secondary to an epidural abscess. Despite no comorbidities and being classified as American Society of Anesthesiologists II, the patient postoperatively reported recalling intraoperative events. Notably, intraoperative findings revealed malfunctioning of the anesthesia machine’s bellows and a vaporizer installation issue. This mishap suggests equipment failure as the potential cause of reduced anesthetic delivery. Using the Brice protocol, the patient’s claims were confirmed as he recalled specific discussions during the operation, though he reported no pain. The team acknowledged and apologized for the awareness incident, assuring patient safety. Awareness, although rare, can be distressing and might result from anesthesia underdosing, equipment failure, or anesthetic application errors. Anesthesiologists must remain vigilant, ensuring equipment functionality, considering increased anesthetic doses when safe, and promptly addressing patient claims of intraoperative awareness. Proper communication, documentation, and patient follow-up are crucial in managing these cases effectively.