Unintentional intraoperative awareness during sufentanil anaesthesia for cardiac surgery

Purpose: The aim of this clinical report is to describe a case of unintentional intraoperative awareness during sufentanil anaesthesia in a patient undergoing elective aortocoronary bypass grafting. Clinical findings: After premedication with morphine (5 mg) and scopolamine (0.2 mg), this 51-yr-old woman received sufentanil (10 mu g . kg(-1)), midazolam (4 mg) and isoflurane (0.3-0.4% end-tidal). The patient recalled specific events and discussions which took place in the operating room during surgery. This patient's report was clear and corroborated by operating room personnel. The patient denied having felt pain, anxiety or emotional distress. Conclusion: Although awareness during opioid anaesthesia has been previously described with morphine and fentanyl, as far as we know this is the first clinical report of awareness with sufentanil. Given that recent efforts of early extubation in cardiac surgery patients may involve a reduction in the amount of opioid administered this report serves as a reminder of the ever present potential for this disturbing complication.