Abstract :
Awareness during anesthesia is an infrequent but a grievous complication with an estimated incidence
of around 0.1% and 0.2% in western world. It is not only troublesome for the patient but can pose
a serious medicolegal threat for anaesthesiologist as well. Preoperative assessment targeting patient’s
characteristics and the type of surgery helps in stratifying the risk of awareness during surgery and provides
a better chance at counseling the patients for the same. Preinduction phase of anaesthesia is an important
phase which includes equipment check and function of monitors and preparation of an adequate plan of
anaesthesia taking into consideration the risk of awareness. Errors in this phase leads to majority of cases
of awareness. With the advent of advance monitoring techniques, the management of anaesthesia has
become even more balanced and helps detect signs of awareness in early stage which can be curtailed
immediately. Postoperative phase can be the most neglected part of anaesthesia in terms of assessment
for any incidence of awareness. A detailed follow-up is always recommended even after discharge and
if awareness is confirmed postoperatively, one must provide explanation to the patient about what has
happened and must be offered both psychological and psychiatric support. In this letter we are going to
briefly talk about factors associated with awareness and measures to avoid them taking into consideration
the medicolegal aspect of the same.
Keyword :
Awareness, Anaesthesia, Medicolegal threats.