López RVO, Solís VG, Álvarez VJ, Sánchez VJ

Language: Spanish
References: 35
Page: 148-153
PDF size: 180.20 Kb.

ABSTRACT

Intraoperative awakening with postoperative memories is documented since 1969. Intraoperative awakening incidence is estimated when interviewing patients in the postoperative. Biespectral index (BSI) has been developed for monitoring the anaesthetic effects in the hypnotic state of the brain being a parameter of continual processed electroencephalography that measures the cerebral activity status. Objective: To establish the incidence of intraoperative awakening in patients for abdominal surgery using the combined anaesthetic technique peridural/general, through the biespectral index and intraoperative movements. Material and methods: A clinical, descriptive, prospective, lineal study in 40 patients programmed for gynecological elective surgery under combined anaesthesia was done. A bispectral index sensor was placed and measurements were made when the patient arrived at the operating room, following induction, and sequentially at the began of surgery and at 15, 30 and 45 minutes from the start. At the end of surgery, having recovered from anaesthesia and at 24 hours patients were asked if they kept a memory of the facts occurred during surgery. Results: Basal mean BSI was 97.5, at induction 58.05, BSI 0 60.65, BSI 15 mean of 62.1, BSI 30 mean of 62.9 and BSI 45 mean 64. The percentage of patients that moved head and thoracic extremities one or more times during the estimated measuring time was 27.5% (11 patients). There was no patient that showed postoperative memories. Conclusion: In the combined anaesthesia a BSI value compatible with the awakening status is shown, nonetheless patients having no postoperative memory.

REFERENCES

1. Mc Intre JW, Bergman NA. Awareness during anesthesia. Br Med J 1969;29:846.

2. Agarwal G, Nunn JF, Tunstall ME. Awareness during anesthesia. A prospective study. Br J Anesth 1977;49(8):835-8.

3. Hurter C, Tomlin PJ. Awareness during anesthesia. Br J Anesth 1978;50(3):307.

4. Waters DJ, Mori DD, Crawford SJ. Awareness in general anesthesia. Br Med J 12(280):811-812.

5. Thornton HL, Cormack RS. Awareness during anesthesia. Anaesthesia 1980;35(6):614.

6. Millay K, Coleman AJ. Awareness during anaesthesia. Ann R Coll Surg Engl 1983;65(4):279-80.

7. Mainzer J Jr, Prys-Roberts C. Awareness, muscle relaxants and balanced anaesthesia. Can Anaesth Soc J 1979;26(5):386-93.

8. Breckenridge JL, Aitkenhead AR. Awareness during anaesthesia: a review. Ann Coll Surg Engl 1983;62(2):93-6.

9. Waters DJ, Crawford JS, Farnsworth GM. Awareness in general anaesthesia. Br Med J 1980;280(6226).

10. Wilson ME, Kelman GR. Awareness in general anaesthesia. Br Med J 1980;280(6226):1270.

11. Bukhari SM, Rathore AH, Kahn MA. Awareness during general anaesthesia. JPMA J Pak Med Assoc 1987;37(6):146-8.

12. Famewo CE, Russell IF. Awareness and dreams during general anaesthesia for caesarian section: a study of incidence. Can Anaesth Soc J 1976;23(6):636-9.

13. Filer FJ, Smoremburg JM, et al. Postanesthetic recall ability, anxiety and dreams in surgical patients. A clinical study. Anesthetist 1986;35(10):609-12.

14. Ghoneim NM, Robert IND, Block RI. Learning and memory during general anesthesia. An update. Anesthesiology 1997;87:387-410.

15. Ghoneim NM, MD. Awareness during anesthesia. Anesthesiology 2000;92(2):597-602.

16. Schacter DI. Implicit memory: History and current status. J Exp Psycol Learn Mem Cogn 1987;134:501-18.

17. Blacher RS. General surgery and anesthesia: The emotional experiences. The Psychological Experiences of surgery. Edited by Blacer RS, New York, John Wiley, 1987:1-25.

18. Lui WHD, Thorp TAS, Graham SG, Aitkenhead AR. Incidence of awareness with recall during general anesthesia. Anaesthesia 1991;46:435-7.

19. Domino KB, Posner KI, Caplan RA, Cheney FW. Awareness during anaesthesia: A closed claims analysis. Anesthesiology 1999;90:1053-61.

20. Sandin RH, Enlund G, Samuelsson P, et al. Awareness during anesthesia: A prospective case study. Lancet 2000;355(9205):707-11.

21. Glass PSA, Sebel PS, Ross C, et al, Improved propofol titration using the biespectral index (BIS). Anesthesiology 1996;85(3):A1056.

22. Sebel PS, Payne F, Gan T, et al. Biespectral analysis (BIS) monitoring improves PACU recovery from propofol alfentanyl/N2O anesthesia. Anesthesiology 1996;85(3A):A468.

23. Payne F, Sebel PS, Glass PSA, et al, Biespectral Index monitoring allows faster emergence from propofol alfentanyl/N2O anesthesia. Anesthesiology 1996;85(3A):A1056.

24. Baron JF, Bertrand M, Barre E, et al. Combined epidural and general anesthesia versus general anesthesia for aortic abdominal surgery. Anesthesiology 1991;75(4):611-8.

25. Lang SA. Combined general/epidural anesthesia. Can J Anaesth 1998;45(9):915.

26. Carli F, Kulbein K, Baker C. Combined epidural/general anaesthesia. Can J Anaesth 1997;44(4):452-3.

27. Bromage PR. Combined epidural/general anaesthesia and postoperative outcome. Can J Anaesth 1997;44(12):1319-20.

28. Liou CM, Kang HM, Lai HC, Liu YC, et al. Will epidural with light general anesthesia increase the incidence of awareness with recall or dream postoperatively. Acta Anaesthesiol Sin 1994;32(4):229-36.

29. Parkhouse J, Faithful NS. Awareness during anaesthesia. Postg Med J 1960;36(674).

30. Turner DJ, Wilson J. Effect of Diazepam on awareness caesarian section under general anaesthesia. Br M J 1969;2:736-737.

31. Jelicic M, Bonke B, Appelboom DK. Indirect memory for words presented during anaesthesia. Lancet 1990;2:249.

32. Block RI, Ghoneim MM, SumPing ST. Human learning during general anaesthesia and surgery. Br J Anaesth 1991;66:170-8.

33. Caseley-Rondi G, Merikle PM, Bowers KS. Unconscious cognition in the context of general anaesthesia. Conscious Cog 1994;3:166-75.

34. Cormack SR, MaCmillan JL. Awareness during surgery-a new approach. Br J Anaesth 1979;51:1051-1059.

35. Schacter DL, Kihlstrom JF, Ghoneim NM. Implicit memory: History and current status. J Exp Psycol 1987;134:501-18.