Lack of awareness

Initial findings from a major study by The Royal College of Anaesthetists (RCoA) and the Association of Anaesthetists of Great Britain and Ireland (AAGBI) looking at how many patients experienced accidental awareness during general anaesthesia showed a very low incidence.

The survey asked all senior anaesthetists in NHS hospitals in the UK (more than 80 percent of whom replied) to report how many cases of accidental awareness during general anaesthesia they encountered in 2011. There are three million general anaesthetics administered each year.

Previous reports have suggested a surprisingly high incidence of awareness of about one in 500 general anaesthetics. The current report found it to be much less common in the UK with one episode known to anaesthetists in every 15,000 general anaesthetics. The report also reports very low use of brain monitoring technology, with only two percent of anaesthetists routinely using it.

The survey is part of a major study called the Fifth National Audit Project (NAP5) taking place over three years. NAP5 is thought to be the largest study of its kind ever conducted and is funded entirely by the profession.

Professor Jaideep Pandit, Consultant Anaesthetist in Oxford and lead author, said, “Anaesthesia is a medical speciality very much focussed on safety and patient experience. We identified accidental awareness during anaesthesia as something, which concerns patients and the profession. The profession is therefore undertaking this major study so that we can better understand the problem and work to reduce the likelihood of it happening to patients.

“We are particularly interested in patient experiences of awareness. Although we know that some patients do suffer distress after these episodes, our survey has found that the vast majority of episodes are brief and do not cause pain or distress.

“Our study will continue to explore the reasons for the differences between our figures and previous reports. Anaesthesia in the UK is administered only by trained doctors and is a consultant-led service. Whether this – or other factors such as differences in patient sensitivity to anaesthetic drugs or different detection rates – influences the reported numbers is something we will be studying in the rest of the project.”

Professor Tim Cook, co-author and a Consultant Anaesthetist in Bath, said, “Risks to patients undergoing general anaesthesia are very small and have decreased considerably in the last decades.

“While our findings are generally reassuring for patients and doctors alike, we recognise that there is still more work to be done. We are spending the next year studying as many of the cases as possible to learn more from patients’ experiences.

“Anaesthetists have always put patients first and will continue to do so.”

Categories: NEWS

About Author