Key result
Processed EEG monitoring is advocated to reduce the risk of awareness with recall during emergency intubation and mechanical ventilation, a complication affecting an estimated 12.3% of paralyzed patients.
Awareness with recall is a significant complication of general anesthesia, particularly when muscle relaxants are used without sufficient hypnotics, highlighting the need for enhanced sedation monitoring.
Awareness with recall during surgery and anesthesia occurs when the hypnotic and amnesic components of a general anesthetic fail to sustain disconnected consciousness and ablate memory. This is a rare yet significant complication that occurs in a small percentage (0.1–0.2%) of patients undergoing surgery under general anaesthesia [ 1 ]. This phenomenon involves the vivid recollection of sensory experiences during surgery, which can lead to posttraumatic stress disorders. The risk of being aware under general anaesthesia in highest in those patients who are administered muscle relaxants without sufficient hypnotics as they are unable to communicate due to paralysis. This event is frequently associated with a number of dramatic feelings (e.g., patients thinking “they were going to die,” sensations of fear and terror, feelings of being unsafe and abandoned or betrayed by doctors and nurses, and pain on being mechanically ventilated).
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Romagnoli et al. (2024) conducted an editorial in Intubated and mechanically ventilated patients. Processed EEG (pEEG) monitoring vs. Clinical signs alone was evaluated. Processed EEG monitoring is advocated to reduce the risk of awareness with recall during emergency intubation and mechanical ventilation, a complication affecting an estimated 12.3% of paralyzed patients.
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