Anaes SAQs · Depth of anaesthesia & awareness
Accidental awareness under general anaesthesia — NAP5 and prevention
Final-viva question on AAGA: definition and classification, the NAP5 risk factors (TIVA, neuromuscular blockade, cardiac/obstetric/trauma), the prevention bundle (end-tidal monitoring, depth monitors, audible alarms), and the compassionate Brice-interview response to a report.
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Prompt
Define accidental awareness under general anaesthesia (AAGA), outline the principal risk factors identified by the Fifth National Audit Project, and describe your approach to preventing it and to responding to a patient who reports it.
Question
Define accidental awareness under general anaesthesia (AAGA), outline the principal risk factors identified by the Fifth National Audit Project, and describe your approach to preventing it and to responding to a patient who reports it[1][2].
References6ShowHide
- [1]Pandit JJ, Andrade J, Bogod DG, et al. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors. Br J Anaesth, 2014.PMID 25204697
- [2]Cook TM, Andrade J, Bogod DG, et al. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent, and medicolegal issues. Br J Anaesth, 2014.PMID 25204696
- [3]Pandit JJ, Andrade J, Bogod DG, et al. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods, and analysis of data. Br J Anaesth, 2014.PMID 25204695
- [4]Myles PS, Leslie K, McNeil J, Forbes A, Chan MT Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Lancet, 2004.PMID 15172773
- [5]Avidan MS, Jacobsohn E, Glick D, et al. Prevention of intraoperative awareness in a high-risk surgical population. N Engl J Med, 2011.PMID 21848460
- [6]Messner M, Beese U, Romstöck J, et al. The bispectral index declines during neuromuscular block in fully awake persons. Anesth Analg, 2003.PMID 12873942