Incidence and Associated Factors of Awareness with Recall under General Anesthesia in Non-cardiac and Non-obstetric Patients in Tikur Anbessa Specialized Hospital, Addis Ababa Ethiopia,2021 G.C
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Date
2021-11
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Addis Ababa University
Abstract
Introduction: General anesthesia is the complex process of administering drugs to induce hypnosis, amnesia, and suppression of stress response to surgical stimuli and create a quit surgical field.
Anesthesia awareness, unintended and unwanted peri-operative adverse event, is characterized by a patient’s ability to recall events happening during anesthesia. Intra-operative awareness may also predispose patients for long-term psychological squealae.
Objective: To assess the incidence and associated risk factors of awareness with recall under general anesthesia in non-cardiac and non-obstetric patients from April – October 2021 G.C in TASH, Addis Ababa, Ethiopia.
Methodology: single-centered institutional based prospective cross sectional study was conducted at Tikur Anbesa Specialized Hospital from April – October 2021 G.C. The modified Brice questionnaire and Aldrete score were used to assess intra-operative awareness with recall under general anesthesia and wakefulness respectively. Patients were selected by systematic random sampling technique and assessed at the PACU and ward. After the data was collected it was entered to SPSS version 25, cleaned and analyzed. Then the degree of association between variables was assessed using logistic regression. Finally, p-value less than 0.05 were considered statistical significant.
Results of the Study: The study population included 354 patients, who underwent surgery under general anesthesia during the study period from April – October 2021 G.C. Male 200 (58.7%) participants were greater than female 141 (41.3%). The minimum and maximum ages of the respondents were 18 and 89 with mean of 39.3+ 15.2 (SD). The incidence of awareness with recall under general anesthesia was 11.7% and the incidence of dreaming found to be 9.1%. Awareness has been associated with the use of muscle relaxant (OR 2.793(1.872-1.948), p value 0.003) and having chronic pain (OR 2.929(1.592-1.821), p value 0.042)
Conclusions: The incidence of awareness in this study was 11.7%. Under the finding of this study, we conclude that the incidence of awareness with recall under general anesthesia is higher than most global studies. However, the risk factors and symptoms of awareness were comparable with most literatures. The use of muscle relaxant and having chronic pain were identified as risk factors in this study. When the incidence of dreaming was 9.3%, being female is a risk factor for dreaming.
Recommendation: The study has recommended the anesthesia provider to give much emphasis on intra-operative awareness, to be vigilant on dosage of relaxant, hypnotics and inhalational, prevention and pain management, follow the patient in the postoperative period, and check anesthesia equipment’s and machine every day for every patient. We recommend the hospital to avail anesthetic gases monitor sensors, and anesthesia depth monitors.
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Awareness,Dreaming,Recall,Generalanesthesia