Levels of Consciousness During Regional Anesthesia and Monitored Anesthesia Care: Patient Expectations and Experiences

In Brief Complaints of “intraoperative awareness” after regional anesthesia and monitored anesthesia care have been reported. We hypothesized that this may be due to either unmet expectations regarding levels of consciousness or states of consciousness resembling general anesthesia. A structured interview assessing expected and experienced levels of consciousness was given to 117 patients who underwent regional anesthesia or monitored anesthesia care. Complete unconsciousness was the state most often expected and subjectively experienced. Furthermore, only 58% of patients had expectations set by the anesthesia provider. These data indicate that, from the patient’s perspective, the boundary between general and nongeneral anesthesia is obscured. IMPLICATIONS: In a study of >100 patients, complete loss of consciousness was the single most frequent expectation and subjective experience of patients undergoing regional anesthesia and monitored anesthesia care. These data indicate that, from the patient’s perspective, the boundary between general and nongeneral anesthesia is obscured.