Victims of awareness

Background: Intraoperative awareness with explicit recall may be followed by long-lasting mental symptoms. However, the average risk for developing mental sequelae after awareness, and the average severity and the duration of symptoms has not previously been illustrated in a consecutive series of awareness cases. Methods: Nine patients among 18 consecutive, prospectively identified cases of intraoperative awareness with recall could be located after approximately 2 years and agreed to an interview about possible persisting problems. Results: Four of the nine interviewed patients were still severely disabled due to psychiatric/psychological sequelae. All of these patients had experienced anxiety during the period of awareness, but only one had complained about pain. Another three patients had less severe, transient mental symptoms, although they could cope with these in daily life. Two patients denied any sequelae from their awareness episode. Conclusions: Up to 3 weeks after their unsuccessful anesthetic, repeated information and discussions had been offered. Despite the fact that all patients at that time claimed to be satisfied with this management, and eventually considered no further contacts necessary, this was obviously inaccurate. Therefore, professional psychiatric assessment, treatment and long-term follow-up should constitute standard practice for all patients who have experienced intracoperative awareness.