Investigation Of Awareness In General Anesthesia

The awareness during general anesthesia is the patients generate sensory perception and memory to the surrounding or sound during general anesthesia,it can be divided into pain sensation awareness and painless sensation awareness. The incidence of awareness can induce psychological stress and unhappy nervous irritation, so the consequence is very serious. The rate of awareness varies from persons to persons just because clinical setting and anesthetic method are different, The rate of awareness is about 2% abroad, but in China, the rate of awareness is ten times over abroad. The objective of this research was to investigate the incidence of awareness during general anesthesia in elective or limited operation, analyzed the risk factors of awareness. 500 patients, underwent general anesthesia during different kinds of elelctive or limited operation in the first hospital of Jilin university. 253 patients were male, 247 patients were female, the average age was (51±15) years. Persons selected standard: Age over 18 years, tracheal intubation, without mental disorder, all the patients did not undertake neuroelectrcity physiological monitoring. Preoperative the doctor visited the patient in routine. Interview was conducted 1days and 4 days postoperatively to survey the incidence of awareness during operation with questionnaire. the questions were just as follow:①Did you remember the last thing before you slept?②Did you remember the first thing after you woke up?③What things could you remember between you slept and woke up?④Did you dream during operation?⑤What was the worst thing you felt during operation? In accordance with the method of Sandin[2], classfied the evaluation standard of awareness into three groups: A. Without awareness: The patient could not remember anything during operation, or the things what the patient described took place before slept or after operation.B. Suspected awareness: The patient dreamed during operation, although the patient could not describe the dream obviously, it might be related with the operation, or the patient had vague memory to the operation. C. Awareness: The patient could describe the operation obviously, it could be judged the things what the patient described took place during operation. If the patient could remember the operation, asked the content of awareness advanced, communicated with the doctor of anesthesia, confirmed the patient's dream. Deal with the result with SPSS 15.0, P<0.05 was the difference had statistical significance. Analyzed the factors possibly influenced the awareness with the method of multiple regression analysis, the possible related factors were the sex,age,weight,class of ASA,anesthetic method,operation time,preanesthetic medication,recirculating state of the patients. The result revealed that: Ten patients (2.0%) were identified as with awareness. One patient could describe the process of operation definitely, other nine patients only talked dreaming during operation and without sense of pain or other sensory perception. The difference between operation type and awareness did not have statistical significance (P>0.05). The sex,age,weight,class of ASA,anesthetic method,operation time,preanesthetic medication,recirculating state of the patients did not have related with awareness (P>0.05). From the resut we could conclude: The rate of awareness during general anesthesia in the first hospital of Jilin university was the same to majority reports in China, about 2%. All the patients with awareness were painless awareness, and did not have psychological sequelae. Awareness could take place in every type of operation, and well-distributed. Many reports considered that sex,preanesthetic medication were the influenced factors of awareness,but in this research they had no obvious dependability with awareness, we can do advanced investigation through applicating the sample or balancing other factors to identify the relationship between sex,preanesthetic medication and awareness of operation. The occurrence of awareness is the result of the influence of multiple foctors. In clinical practice, insufficiency of anesthesia, increasing tolerance dose of patients to the junk, misuse of the instrumentation such as anesthetic machine, widespread application of mucle relaxant, all above can lead to the occurrence of awareness. To avoid the occurrence of awareness, anesthesiologists should flawless theory knowledge and anesthetic technic, cooperate with surgeon, guarantee every link connecting tightly during general anesthesia.