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New survey reports low rate of patient awareness during anaesthesia.

The Royal College of Anesthetists (RCoA) and the Association of Anesthetists of Great Britain and Ireland (AAGBI) today publish initial findings from a major study which looked at how many patients experienced accidental awareness during general anesthesia.

The survey asked all senior anesthetists in NHS hospitals in the UK (more than 80% of whom replied) to report how many cases of accidental awareness during general anesthesia they encountered in 2011. There are three million general anesthetics administered each year. Study findings are published in Anesthesia, and The British Journal of Anesthesia, the peer-reviewed journals of the AAGBI, and RCoA respectively.

Previous reports have suggested a surprisingly high incidence of awareness of about one in 500 general anesthetics. The current report found it to be much less common in the UK with one episode known to anesthetists in every 15,000 general anesthetics. The report also reports very low use of brain monitoring technology: with only 2% of anesthetists 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 Anesthetist in Oxford and lead author, said, "Anesthesia is a medical specialty very much focused on safety and patient experience. We identified accidental awareness during anesthesia 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. Anesthesia 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 anesthetic drugs or different detection rates influence the reported numbers - is something we will be studying in the rest of the project."

Professor Tim Cook, co-author and a Consultant Anesthetist in Bath said, "Risks to patients undergoing general anesthesia are very small and have decreased considerably in the last decades. Anesthesia doctors in the UK undergo the same level of training as surgeons and physicians. Of the three million general anesthetics administered in the NHS each year, only a very small number of patients experience awareness during anesthesia, with the majority of these occurring before surgery starts or after it finishes."

"While our findings are generally reassuring for patients and doctors alike, we recognize 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. It is hoped that the findings included in the final report, due out early 2014, will increase our understanding of accidental awareness during general anesthesia so that the anesthetic profession can further increase safety for patients."

"Anesthetists have always put patients first and will continue to do so. This study, which comes just after the publication of the Francis report, shows that anesthetists are clearly listening to patients and have acted positively to address a major patient concern."
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Publication:Pulse International
Geographic Code:4EUUK
Date:Mar 31, 2013
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