@article{7875570cda16444b80f623c016df20d5,
title = "Increased risk of intraoperative awareness in patients with a history of awareness",
abstract = "Background: Patients with a history of intraoperative awareness with explicit recall (AWR) are hypothesized to be at higher risk for AWR than the general surgical population. In this study, the authors assessed whether patients with a history of AWR (1) are actually at higher risk for AWR; (2) receive different anesthetic management; and (3) are relatively resistant to the hypnotic actions of volatile anesthetics. Methods: Patients with a history of AWR and matched controls from three randomized clinical trials investigating prevention of AWR were compared for relative risk of AWR. Anesthetic management was compared with the use of the Hotelling's T2 statistic. A linear mixed model, including previously identified covariates, assessed the effects of a history of AWR on the relationship between end-Tidal anesthetic concentration and bispectral index. Results: The incidence of AWR was 1.7% (4 of 241) in patients with a history of AWR and 0.3% (4 of 1,205) in control patients (relative risk = 5.0; 95% CI, 1.3-19.9). Anesthetic management did not differ between cohorts, but there was a significant effect of a history of AWR on the end-Tidal anesthetic concentration versus bispectral index relationship. Conclusions: Surgical patients with a history of AWR are five times more likely to experience AWR than similar patients without a history of AWR. Further consideration should be given to modifying perioperative care and postoperative evaluation of patients with a history of AWR.",
author = "Amrita Aranake and Stephen Gradwohl and Arbi Ben-Abdallah and Nan Lin and Amy Shanks and Helsten, {Daniel L.} and Glick, {David B.} and Eric Jacobsohn and Villafranca, {Alex J.} and Evers, {Alex S.} and Avidan, {Michael S.} and Mashour, {George A.}",
note = "Funding Information: Received from the Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan, and the Department of Anesthesiology, Washington University, Saint Louis, Missouri. Submitted for publication December 9, 2012. Accepted for publication April 18, 2013. The Michigan Awareness Control Study was generously funded by the Cerebral Function Monitoring grant (Dr. Mashour, Principal Investigator) from the Foundation for Anesthesia Education and Research, Rochester, Minnesota; the American Society of Anesthesiologists, Park Ridge, Illinois; the National Institutes of Health (NIH), Bethesda, Maryland (KL2 RR024987-01) (to Dr. Mashour); and the Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan. The B-Unaware Trial was supported by grant 604302 from the Barnes-Jewish Hospital Foundation (to Dr. Avidan), St. Louis, Missouri, as well as institutional and departmental sources. The BAG-RECALL trial was supported by a grant (CFM-08/15/2007-Avidan) awarded by the Foundation for Anesthesia Education and Research, Rochester, Minnesota; and the American Society of Anesthesiologists, Park Ridge, Illinois (Dr. Avidan, Principal Investigator); as well as institutional and departmental sources. Amrita Aranake is a predoctoral research trainee who received a grant (grant number UL1 RR024992 and sub-award number TL1 RR024995) from the National Center for Research Resources (NCRR), Bethesda, Maryland, a component of the NIH and the NIH Roadmap for Medical Research. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. The authors declare no competing interests. Drs. Avidan and Mashour contributed equally to this article. Funding Information: The Michigan Awareness Control Study was generously funded by the Cerebral Function Monitoring grant (Dr. Mashour, Principal Investigator) from the Foundation for Anesthesia Education and Research, Rochester, Minnesota; the American Society of Anesthesiologists, Park Ridge, Illinois; the National Institutes of Health (NIH), Bethesda, Maryland (KL2RR024987-01) (to Dr. Mashour); and the Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan. The B-Unaware Trial was supported by grant 604302 from the Barnes- Jewish Hospital Foundation (to Dr. Avidan), St. Louis, Missouri, as well as institutional and departmental sources. The BAG-RECALL trial was supported by a grant (CFM-08/15/2007-Avidan) awarded by the Foundation for Anesthesia Education and Research, Rochester, Minnesota; and the American Society of Anesthesiologists, Park Ridge, Illinois (Dr. Avidan, Principal Investigator); as well as institutional and departmental sources. Amrita Aranake is a predoctoral research trainee who received a grant (grant number UL1 RR024992 and sub-Award number TL1 RR024995) from the National Center for Research Resources (NCRR), Bethesda, Maryland, a component of the NIH and the NIH Roadmap for Medical Research. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. The authors declare no competing interests. Drs. Avidan and Mashour contributed equally to this article. Publisher Copyright: Copyright {\textcopyright} 2013, the American Society of Anesthesiologists, Inc.",
year = "2013",
month = dec,
doi = "10.1097/ALN.0000000000000023",
language = "English",
volume = "119",
pages = "1275--1283",
journal = "Anesthesiology",
issn = "0003-3022",
number = "6",
}