Key result
Accidental awareness during general anesthesia in children has an estimated incidence between 1 in 135 and 1 in 51,500, with approximately 70% of cases occurring at induction or emergence.
Accidental awareness during general anesthesia in children is a distressing event that varies widely in reported incidence depending on the detection method, highlighting the need for sympathetic management and potential use of depth of anesthesia monitoring during TIVA.
AAGA incidence in children varies widely by detection method with frequent distress; leaves open optimal monitoring and prevention strategies pending prospective data.
This educational review explores the current understanding of accidental awareness during general anesthesia (AAGA) in children. Estimates of incidence in children vary between 1 in 135 (determined by direct questioning) and 1 in 51,500 (determined from spontaneous reporting). The lessons from the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland show that the characteristics of spontaneous reports of AAGA are extremely variable and relate to the type of procedure and anesthetic technique rather than age group: approximately 50% of experiences were distressing; most lasted less than 5 min; neuromuscular blockade (NMB) combined with pain caused the most distress; most cases (approximately 70%) occur at induction or emergence. The value of depth of anesthesia monitoring in preventing AAGA is uncertain but is probably useful in patients having total intravenous anesthesia and NMB. Reports of AAGA by children should be received sympathetically and a generic protocol for managing distressed patients is presented.
No takes yet. Share an insight, caveat, or question.
Michael R. J. Sury (2016) conducted a review in Accidental awareness during general anesthesia (AAGA). General anesthesia was evaluated on Incidence of accidental awareness during general anesthesia. Accidental awareness during general anesthesia in children has an estimated incidence between 1 in 135 and 1 in 51,500, with approximately 70% of cases occurring at induction or emergence.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: