Anesthesiologists must proactively manage the risk of awareness and recall to prevent severe psychological consequences for patients and legal repercussions.
Urges proactive anesthesia vigilance to mitigate patient trauma and liability; leaves open optimal prevention strategies for prospective study.
Awareness and recall under anesthesia is a complication that appears to be related to the use of muscle relaxants. While little is known about unconscious awareness and its physical and psychological consequences, it is well known that recall can result in traumatic psychological sequelae under certain circumstances. The anesthesiologist must be aware of the possibility of awareness before it occurs and either try to avoid it or explain to the patient the possibility of awareness and the circumstances under which it might occur. In the event of unexpected awareness, the anesthesiologist must deal with the patient in an honest and forthright manner. Failure to do so may lead to dire psychological consequences for the patient and legal consequences for the anesthesiologist.
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Frank Guerra (1986) studied this question.
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