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1. Bispectral index for improving intraoperative awareness and early postoperative recovery in adults. (PubMed)

Bispectral index for improving intraoperative awareness and early postoperative recovery in adults. The use of clinical signs, or end-tidal anaesthetic gas (ETAG), may not be reliable in measuring the hypnotic component of anaesthesia and may lead to either overdosage or underdosage resulting in adverse effects because of too deep or too light anaesthesia. Intraoperative awareness, whilst uncommon, may lead to serious psychological disturbance, and alternative methods to monitor the depth (...) of anaesthesia may reduce the incidence of serious events. Bispectral index (BIS) is a numerical scale based on electrical activity in the brain. Using a BIS monitor to guide the dose of anaesthetic may have advantages over clinical signs or ETAG. This is an update of a review last published in 2014.To assess the effectiveness of BIS to reduce the risk of intraoperative awareness and early recovery times from general anaesthesia in adults undergoing surgery.We searched CENTRAL, MEDLINE, Embase, and Web

2019 Cochrane

2. Concise practice guidance on the prevention and management of accidental awareness during general anaesthesia

Concise practice guidance on the prevention and management of accidental awareness during general anaesthesia Guidelines The ‘NAP5 Handbook’ Concise practice guidance on the prevention and management of accidental awareness during general anaesthesia March 2019 Published by the Association of Anaesthetists and the Royal College of Anaesthetists2 Association of Anaesthetists Association of Anaesthetists 2 The ‘NAP5 Handbook’ Concise practice guidance on the prevention and management (...) of accidental awareness during general anaesthesia Membership of the working party J. J Pandit 1 , T. M Cook 2 , S. Shinde 3 , K. Ferguson 4 , J. Hitchman 5 , W. Jonker 6 , P . M Odor 7 , T. Meek 8 1 Consultant, Nuffield Department of Anaesthesia, Oxford University Hospitals NHS Trust, Oxford, UK (Co-Chair, Working Party on behalf of the Royal College of Anaesthetists) 2 Consultant, Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK (on behalf of Royal College

2019 Association of Anaesthetists of GB and Ireland

3. Nitrous oxide-based versus nitrous oxide-free general anaesthesia and accidental awareness during general anaesthesia in surgical patients. (PubMed)

Nitrous oxide-based versus nitrous oxide-free general anaesthesia and accidental awareness during general anaesthesia in surgical patients. Accidental awareness during general anaesthesia (AAGA) is when a patient unintentionally becomes conscious during a procedure performed with general anaesthesia and subsequently has explicit recall of this event. Incidence estimates for AAGA vary, with the most common estimate being one to two cases per 1000 general anaesthetics. Evidence linking nitrous (...) using the GRADE approach. Other types of bias were generally low, or were rated unclear due to missing information.No studies were designed to measure AAGA as the primary outcome, and were therefore statistically underpowered to answer this review question. Despite the inclusion of 3520 participants, only three awareness events were reported by two studies. In one study the event was due to technical failure. Due to the rarity of the events, we did not consider it appropriate to pool the data

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2016 Cochrane

4. Nurses should inform patients of the possibility of awareness during bronchoscopy performed with procedural sedation

Nurses should inform patients of the possibility of awareness during bronchoscopy performed with procedural sedation Nurses should inform patients of the possibility of awareness during bronchoscopy performed with procedural sedation | Evidence-Based Nursing We use cookies to improve our service and to tailor our content and advertising to you. You can manage your cookie settings via your browser at any time. To learn more about how we use cookies, please see our . Log in using your username (...) and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? Search for this keyword Search for this keyword Main menu Log in using your username and password For personal accounts OR managers of institutional accounts Username * Password * your user name or password? You are here Nurses should inform patients of the possibility of awareness during bronchoscopy performed with procedural sedation Article Text Commentary Adult nursing Nurses

2018 Evidence-Based Nursing

5. Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia (PubMed)

Awareness of epidural analgesia among pregnant women in Jeddah, Saudi Arabia Labor pain is one of the most severe forms of pain that women experience throughout their lifetime. Many pregnant women decide to have an epidural anesthesia to cope with labor pain. This study has focused on general awareness about epidural anesthesia among pregnant women in Jeddah, Saudi Arabia.This was a cross-sectional hospital-based study using a self-administered questionnaire, conducted in King Faisal Specialist

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2017 Electronic physician

6. Genetic Analysis of Patients Who Experienced Awareness with Recall while under General Anesthesia. (PubMed)

Genetic Analysis of Patients Who Experienced Awareness with Recall while under General Anesthesia. The incidence of explicit recall of intraoperative events, or awareness with recall, is less than 0.2%Anesthetic dosing is apparently adequate in 10 to 25% of awareness with recall patientsThe awareness with recall phenotype only reveals itself when patients are exposed to anesthesia WHAT THIS ARTICLE TELLS US THAT IS NEW: A preliminary study sought to determine whether there is evidence (...) that awareness with recall is caused by a few rare variants with high penetrance in 12 patients who had experienced awareness with recall in the presence of apparently adequate anesthesiaWhole exome sequencing was conducted and identified variants were filtered and prioritized to identify a candidate list that might be suitable for further investigation of causes of awareness with recallNo candidate gene(s) suggestive of a monogenic etiology were identified, possibly because of the application of a filtering

2019 Anesthesiology

7. Intraoperative Awareness With Recall: A Descriptive, Survey-Based, Cohort Study. (PubMed)

Intraoperative Awareness With Recall: A Descriptive, Survey-Based, Cohort Study. Unintended intraoperative awareness with recall (AWR) is a potential complication of general anesthesia. Patients typically report recollections of (1) hearing sounds or conversations, (2) being unable to breathe or move, (3), feeling pain, and/or (4) experiencing emotional distress. The purpose of the current study was to identify and further characterize AWR experiences identified through postoperative surveys

2019 Anesthesia and Analgesia

8. Inhalation of volatile anesthetics via a laryngeal mask is associated with lower incidence of intraoperative awareness in non-critically ill patients. (PubMed)

Inhalation of volatile anesthetics via a laryngeal mask is associated with lower incidence of intraoperative awareness in non-critically ill patients. Increased incidence of intraoperative awareness was reported in critically ill patients during major operations, particularly under total intravenous (TIVA) or endotracheal general anesthesia (ETGA). However, the incidence and effect of anesthesia techniques on awareness in generally healthy, non-critically ill patients during operations have yet (...) to receive significant attention.This retrospective matched case-control study was conducted between January 2009 to December 2014. Surgical patients (ASA physical status I-III) whom reported intraoperative awareness during this study period were interviewed and their medical records were reviewed. The potential risk factors for awareness were compared with the non-case matched controls, who were randomly selected from the database. A total of 61436 patients were included and 16 definite cases

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2017 PLoS ONE

9. Does post-operative knee awareness differ between knees in bilateral simultaneous total knee arthroplasty? Predictors of high or low knee awareness. (PubMed)

Does post-operative knee awareness differ between knees in bilateral simultaneous total knee arthroplasty? Predictors of high or low knee awareness. To evaluate the difference in post-operative knee awareness between knees in patients undergoing bilateral simultaneous total knee arthroplasty (TKA) and to assess factors predicting high or low knee awareness.This study was conducted on 99 bilateral simultaneous TKAs performed at our institution from 2008 to 2012. All patients received one set (...) of questionnaires [Forgotten Joint Score (FJS) and Oxford Knee Score (OKS)] for each knee. Based on the FJS, the patients' knees were divided into two groups: "best" and "worst" knees. The median of the absolute difference in FJS and OKS within each patient was calculated. Multivariate linear regression was performed to identify factors affecting FJS.The difference between knees was 1 point (CI 0-5) for the FJS and 1 point (CI 0-2) for the OKS. The FJS for females increased (decreasing awareness

2016 Knee Surgery, Sports Traumatology, Arthroscopy

10. Dreaming and awareness during dexmedetomidine- and propofol-induced unresponsiveness. (PubMed)

Dreaming and awareness during dexmedetomidine- and propofol-induced unresponsiveness. Experiences during anaesthetic-induced unresponsiveness have previously been investigated by interviews after recovery. To explore whether experiences occur during drug administration, we interviewed participants during target-controlled infusion (TCI) of dexmedetomidine or propofol and after recovery.Healthy participants received dexmedetomidine (n=23) or propofol (n=24) in stepwise increments until loss (...) generated experiences (awareness) were rare and linked to brief arousals. No within drug differences in the prevalence or content of experiences during infusion vs after recovery were observed, but participants receiving dexmedetomidine reported dreaming and awareness more often. Participants receiving dexmedetomidine recognised the emotional sounds better than participants receiving propofol (42% vs 15%), but none reported references to sounds spontaneously.Anaesthetic-induced unresponsiveness does

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2018 British Journal of Anaesthesia

11. Accidental awareness during general anaesthesia - a narrative review. (PubMed)

Accidental awareness during general anaesthesia - a narrative review. Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated (...) forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness. For example, the ConsCIOUS-1 study showed an incidence of responsiveness around the time of laryngoscopy of 1:25. On the other hand, the 5th Royal College of Anaesthetists National Audit Project, which reported the largest ever cohort of patients who had experienced accidental awareness, used a system to identify patients who spontaneously self-reported accidental

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2018 Anaesthesia

12. Improving local anaesthetic systemic toxicity (LAST) awareness in maternity care using tailored educational tools (PubMed)

Improving local anaesthetic systemic toxicity (LAST) awareness in maternity care using tailored educational tools Local anaesthetic (LA) agents are widely used in maternity care. Although relatively safe, their use does carry risks, the most serious of which is systemic toxicity (LAST). LAST poses a major threat to maternal and neonatal safety due to the frequency of LA administration in maternity care and the under-recognition of toxicity in such settings, which has been reported globally. Our (...) aim was to prevent LAST occurrence in a District General Hospital (DGH) maternity unit by improving staff awareness through the implementation of a tailored educational programme. We used a standardised 14-point questionnaire to evaluate LAST awareness among staff of all disciplines. Domains of interest were LA maximum safe doses, LAST recognition, immediate management and use of antidote. Following baseline assessment, we implemented an educational programme in three stages. Each featured

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2018 BMJ Open Quality

13. Incidence of Intraoperative Awareness in Indian Patient Population

Incidence of Intraoperative Awareness in Indian Patient Population Incidence of Intraoperative Awareness in Indian Patient Population - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Incidence (...) of Intraoperative Awareness in Indian Patient Population The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details. ClinicalTrials.gov Identifier: NCT03571945 Recruitment Status : Recruiting First Posted : June 28, 2018 Last Update Posted : November 27, 2018 See Sponsor: Sir

2018 Clinical Trials

14. Awareness, incidence and clinical significance of acute kidney injury after non-general anesthesia: A retrospective cohort study: Erratum (PubMed)

Awareness, incidence and clinical significance of acute kidney injury after non-general anesthesia: A retrospective cohort study: Erratum 30278584 2018 11 14 1536-5964 97 39 2018 Sep Medicine Medicine (Baltimore) Awareness, incidence and clinical significance of acute kidney injury after non-general anesthesia: A retrospective cohort study: Erratum. e12628 10.1097/MD.0000000000012628 eng Journal Article United States Medicine (Baltimore) 2985248R 0025-7974 2018 10 4 6 0 2018 10 4 6 0 2018 10 4

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2018 Medicine

15. Awareness, incidence and clinical significance of acute kidney injury after non-general anesthesia: A retrospective cohort study. (PubMed)

Awareness, incidence and clinical significance of acute kidney injury after non-general anesthesia: A retrospective cohort study. Postoperative acute kidney injury is associated with high mortality and poor prognosis. Additional investigations into the risk factors for this condition and the outcomes of patients who undergo surgeries under non-general anesthesia (GA) are necessary.This retrospective cohort study included data on all surgeries performed in adult patients from January 2006

2018 Medicine

16. A Survey of Charge Sensitivity and Charge Awareness Among Intensive Care Unit Providers in a Large Academic Medical Center. (PubMed)

A Survey of Charge Sensitivity and Charge Awareness Among Intensive Care Unit Providers in a Large Academic Medical Center. Little is known about charge sensitivity or charge awareness among intensive care unit (ICU) providers in the United States. In a survey of 295 ICU providers at a large, academic medical center, 92.5% of respondents agreed that controlling health care expenses is partly their responsibility. However, 87.4% of respondents reported that they did not know the charges for most (...) of the tests and medications they prescribe. Among surveyed participants, the correct charge for a medical procedure or test was selected only 35% of the time. While ICU providers overwhelmingly agree that controlling expenses is their responsibility, charge awareness is low and likely limits their ability to make value-based decisions.

2018 Anesthesia and Analgesia

17. Effects of remifentanil and dexmedetomidine on the mother’s awareness and neonatal Apgar scores in caesarean section under general anaesthesia (PubMed)

Effects of remifentanil and dexmedetomidine on the mother’s awareness and neonatal Apgar scores in caesarean section under general anaesthesia Objective This study aimed to compare the effects of remifentanil and dexmedetomidine on awareness during the induction of general anaesthesia. Material and Methods Ninety patients scheduled for elective caesarean section under general anaesthesia were included and randomly divided into three anaesthesia groups: 2 mg/kg propofol (control group); 2 mg (...) to the isolated arm technique during the induction period was also similar. One-minute Apgar scores in the control group were significantly lower and 5-minute Apgar scores significantly higher than those in the other groups. Conclusion The effects of remifentanil and dexmedetomidine added to propofol on maternal awareness, neonatal Apgar scores, and bispectral index values were similar compared with propofol alone. However, it was observed that remifentanil controlled the haemodynamic responses to sympathetic

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2018 The Journal of international medical research

18. Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: a cluster-randomized controlled trial. (PubMed)

Emotional awareness and expression therapy, cognitive behavioral therapy, and education for fibromyalgia: a cluster-randomized controlled trial. Patients with fibromyalgia (FM) experience increased lifetime levels of psychosocial adversity, trauma, and emotional conflict. To address these risk factors, we developed emotion awareness and expression therapy (EAET) and tested its benefits against an active control condition, FM education, and the field's gold standard intervention for FM (...) better outcomes than FM education on overall symptoms, widespread pain, physical functioning, cognitive dysfunction, anxiety, depression, positive affect, and life satisfaction (between-condition d's ranging from 0.29-0.45 SD) and the percentage of patients reporting being "very much/much" improved (34.8% vs 15.4%). Emotional awareness and expression therapy did not differ from CBT on the primary or most secondary outcomes, but compared to CBT, EAET led to significantly lower FM symptoms (d = 0.35

2018 Pain Controlled trial quality: uncertain

19. Effect of magnesium sulfate on anesthesia depth, awareness incidence, and postoperative pain scores in obstetric patients: A double-blind randomized controlled trial (PubMed)

Effect of magnesium sulfate on anesthesia depth, awareness incidence, and postoperative pain scores in obstetric patients: A double-blind randomized controlled trial To assess the effects of magnesium on the depth of anesthesia and to determine the effects of magnesium on incidence of awareness and postoperative pain after caesarean section.  Methods: The study was designed as a double-blind, controlled, randomized study and conducted in Hacettepe University Hospital, Ankara, Turkey  between (...) and desflurane were kept constant. Bispectral index scores (BIS), fentanyl consumption and postoperative visual analogue scale (VAS) values were recorded. All of the patients had been followed-up for awareness until the postoperative first year. Results: Demographic variables of the patients were similar. BIS values were significantly higher in control groups throughout the operation (p less than 0.001). No significant difference was detected for intraoperative fentanyl consumption and awareness incidence

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2018 Saudi medical journal Controlled trial quality: uncertain

20. Lebanese women׳s awareness and attitude toward epidural anesthesia during labor (PubMed)

Lebanese women׳s awareness and attitude toward epidural anesthesia during labor Women׳s choice to use epidural anesthesia (EA) for relief of labor pain varies from one culture to another. A descriptive cross-sectional design was used to gather data from a sample of 200 women in childbearing age. Data was gathered from general population in Lebanon. Demographic data, knowledge and attitudes questionnaires towards EA were used to gather data for this study. The data in this article provides (...) demographic data about Lebanese women and their awareness and attitudes towards epidural anesthesia. The analyzed data is provided in the tables included in this article.

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2018 Data in brief

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