General anesthesia: awareness

Obstetrics carries the highest awareness risk of any surgery.

Accidental awareness during general anesthesia means being conscious during surgery while unable to move. Across all surgery in a UK national audit, it occurred in roughly 1 in 19,600 anesthetics. For cesarean delivery under general anesthesia, the rate was roughly 1 in 670.

The reason is specific to obstetrics. Anesthetic doses are kept deliberately light to protect the baby, and the situation is usually urgent.

1 in 670

Awareness during general anesthesia for cesarean

UK national audit

1 in 19,600

Awareness across all surgery

Same audit

This is a strong argument for regional anesthesia whenever there is time for it, and a strong argument for telling any woman facing general anesthesia that this is a known risk.

Where this comes from

Pandit JJ, Andrade J, Bogod DG, et al. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors. Br J Anaesth. 2014;113(4):549-559.

Covered in the class

2Module 2. The five ways your pain can be controlledAn epidural, a spinal, a general anesthetic, medicine through a drip, and local. What each one is, when it is used, and what it costs you. 5Module 5. How a cesarean is anesthetized, and what the room is likeAwake for almost all of them. What is placed, what is raised, and what you will hear and smell.

Continue

Read this inside the full program, with the questions to take to your next visit and a record of what you have covered.

Obstetric Anesthesia Preparedness →

More from Anesthesia

How cesareans are anesthetizedAlmost all are awake. A minority are not. Side effects of a spinal during the operationLow blood pressure, nausea, shivering and itching are all common. General anesthesia: the breathing tube and the stomachTwo specific risks that make obstetric general anesthesia harder. Pain during the operationThe single most under-disclosed fact in cesarean consent.

This page is educational. It supports the conversation with your own clinicians. It is not consent to any treatment, and it cannot assess you.