Incidence, Associated Factors, and Behavioral Consequences of Intraoperative Awareness and Dreams During General Anesthesia Among Adult Patients: A Prospective Cohort Study
Roudha Mattar Al Jabri, Jyoti Burad, Al Muayad Al Moosa
Cureus June 1, 2024 DOI: 10.7759/cureus.62843 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Prospective cohort study Peer reviewed |
|---|---|
| Sample size | 300 |
| Population | Adult Omani patients undergoing general anesthesia at a tertiary-level hospital |
| Duration | Assessed in the post-anesthesia care unit, then at home on the seventh day and one month telephonically |
| Measures | modified Brice questionnaire |
| Key findings | Intraoperative awareness occurred in 0.3% of patients and intraoperative dreams in 7.6%; 49.33% reported postoperative psychological effects such as anxiety, irritability, fear of surgery, memory change, and repetitive nightmares. No factor was significantly associated with these outcomes, and the authors suggest awareness may be linked to prolonged recovery and neuromuscular blocking agents, though they call for larger studies to confirm this. |
Abstract
Background: The intraoperative awareness with recall phenomenon involves the memory of intraoperative events. The reported incidence is 0.001%. Awareness is rare intraoperatively but has profound implications. This research aimed to study intraoperative awareness and dream experiences in the Omani population undergoing general anesthesia.
Methods: This prospective cohort study involving 300 adult patients was conducted at a tertiary-level hospital between July and December 2021. Awareness was assessed in the post-anesthesia care unit and then at home on the seventh day and one month telephonically using a modified Brice questionnaire. The study's primary outcome was the incidence of IOA and dreams in adult Omani patients undergoing GA. The secondary outcome was identifying the factors associated with intraoperative awareness and dreams under GA.
Results: In this study, the incidence of awareness was 0.3% while 7.6% of patients reported intraoperative dreams. The patient who experienced IOA underwent an endoscopic retrograde cholangiopancreatography under GA with neuromuscular blockade and had a prolonged recovery. A total of 49.33% developed psychological effects postoperatively; anxiety, irritability, fear of surgery, change in memory, and repetitive nightmares were the most common ones. Because of the limited sample size, no factor associated significantly with these outcomes was found.
Conclusion: This study observed a higher incidence of intraoperative awareness and dreams. Awareness might be due to prolonged recovery and the use of neuromuscular blocking agents, but a focused study is required to confirm this finding. The incidence of intraoperative dreams and postoperative psychological effects of GA was also high. It may be worth exploring these findings with larger population-based research.