Intraoperative Awareness
Consciousness Monitors
Awareness
Anesthesia, General
Monitoring, Intraoperative
Anesthetics
Intraoperative Care
Effect of earplugs on propofol requirement and awareness with recall during spinal anesthesia. (1/22)
investigator either placed or did not place earplugs into the patients' ears (PLUG or noPLUG groups, respectively). Propofol requirements for stable sedation guided by the bispectral index and incidence of postoperative recall of intraoperative events were assessed in a double-blinded fashion. RESULTS: We found high but comparable propofol requirements in both groups (PLUG 4.4+/-1.2 vs. noPLUG 4.2+/-1.0 mg kg-1 h-1, p=NS). The incidence of intraoperative awareness was lower in the PLUG compared to the noPLUG group (16 vs. 56%; P<0.001). CONCLUSION: Although no sedative-sparing effect could be found in patients who wore earplugs during elective orthopedic surgery under spinal anesthesia, we nevertheless recommend using single-use paraffin wax earplugs. Beside their beneficial effect against potential harmful intraoperative noise, they reduce the incidence of intraoperative awareness with recall. (+info)Awareness during anesthesia: a problem without solutions? (2/22)
Awareness during anesthesia has been the subject of much research and commentary in recent years. In this article, we review the recent publications in the area of anesthesia awareness and attempt to answer the question: Is awareness a problem without solutions? The incidence of awareness has been reported in benchmark studies to be about 0.1%, but two recent studies in Spain and China have reported incidences of awareness of 1% and 0.4%, respectively. Recent studies have confirmed that awareness is more common in women undergoing cesarean sections (0.26%) and in children (0.5-1%). There are very few trials that provide strong evidence for awareness prevention strategies. The best current evidence from one randomized trial suggests that bispectral index monitoring identifies the presence and reduces the incidence of awareness in high-risk patients. More trials are needed and two large ongoing trials are exploring the value of monitoring end-tidal gas concentrations and maintaining adequate age-adjusted values during surgery as an alternative method to prevent awareness. (+info)Intra-operative behavioral tasks in awake humans undergoing deep brain stimulation surgery. (3/22)
(+info)Awareness under general anesthesia. (4/22)
(+info)Bispectral index monitoring, duration of bispectral index below 45, patient risk factors, and intermediate-term mortality after noncardiac surgery in the B-Unaware Trial. (5/22)
(+info)Intraoperative awareness: from neurobiology to clinical practice. (6/22)
(+info)Prevention of intraoperative awareness in a high-risk surgical population. (7/22)
(+info)aepEX monitor for the measurement of hypnotic depth in patients undergoing balanced xenon anaesthesia. (8/22)
(+info)Intraoperative awareness is a situation in which a patient under general anesthesia experiences some or all aspects of surgical manipulations, consciousness, and/or awareness of the surrounding environment, despite being administered anesthetic drugs to produce unconsciousness. It is also known as unintended intraoperative awareness or accidental awareness during general anesthesia. This rare but potentially distressing complication can lead to psychological disturbances such as post-traumatic stress disorder (PTSD), anxiety, and sleep disorders. Careful monitoring of the depth of anesthesia and effective communication between the anesthesiologist, surgeon, and patient help reduce the incidence of intraoperative awareness.
I'm not aware of a specific medical definition for "consciousness monitors." The term "consciousness" generally refers to an individual's state of being awake and aware of their surroundings and experiences. In a medical context, healthcare professionals may monitor a person's level of consciousness as part of their overall assessment of the patient's neurological status.
There are several tools and scales that healthcare providers use to assess a person's level of consciousness, including:
1. The Glasgow Coma Scale (GCS): This is a widely used tool for assessing level of consciousness in patients with traumatic brain injury or other conditions that may affect consciousness. The GCS evaluates a patient's ability to open their eyes, speak, and move in response to stimuli.
2. The Alert, Voice, Pain, Unresponsive (AVPU) scale: This is another tool used to assess level of consciousness. It evaluates whether a patient is alert, responds to voice, responds to pain, or is unresponsive.
3. Pupillary response: Healthcare providers may also monitor the size and reactivity of a person's pupils as an indicator of their level of consciousness. Changes in pupil size or reactivity can be a sign of brainstem dysfunction or increased intracranial pressure.
It's important to note that while healthcare professionals may monitor a patient's level of consciousness, there is no single device or tool that can directly measure "consciousness" itself. Instead, these tools and assessments provide valuable information about a person's neurological status and help healthcare providers make informed decisions about their care.
In a medical context, awareness generally refers to the state of being conscious or cognizant of something. This can include being aware of one's own thoughts, feelings, and experiences, as well as being aware of external events or sensations.
For example, a person who is awake and alert is said to have full awareness, while someone who is in a coma or under general anesthesia may be described as having reduced or absent awareness. Similarly, a person with dementia or Alzheimer's disease may have impaired awareness of their surroundings or of their own memory and cognitive abilities.
In some cases, awareness may also refer to the process of becoming informed or educated about a particular health condition or medical treatment. For example, a patient may be encouraged to increase their awareness of heart disease risk factors or of the potential side effects of a medication. Overall, awareness involves a deep understanding and perception of oneself and one's environment.
General anesthesia is a state of controlled unconsciousness, induced by administering various medications, that eliminates awareness, movement, and pain sensation during medical procedures. It involves the use of a combination of intravenous and inhaled drugs to produce a reversible loss of consciousness, allowing patients to undergo surgical or diagnostic interventions safely and comfortably. The depth and duration of anesthesia are carefully monitored and adjusted throughout the procedure by an anesthesiologist or certified registered nurse anesthetist (CRNA) to ensure patient safety and optimize recovery. General anesthesia is typically used for more extensive surgical procedures, such as open-heart surgery, major orthopedic surgeries, and neurosurgery.
The intraoperative period is the phase of surgical treatment that refers to the time during which the surgery is being performed. It begins when the anesthesia is administered and the patient is prepared for the operation, and it ends when the surgery is completed, the anesthesia is discontinued, and the patient is transferred to the recovery room or intensive care unit (ICU).
During the intraoperative period, the surgical team, including surgeons, anesthesiologists, nurses, and other healthcare professionals, work together to carry out the surgical procedure safely and effectively. The anesthesiologist monitors the patient's vital signs, such as heart rate, blood pressure, oxygen saturation, and body temperature, throughout the surgery to ensure that the patient remains stable and does not experience any complications.
The surgeon performs the operation, using various surgical techniques and instruments to achieve the desired outcome. The surgical team also takes measures to prevent infection, control bleeding, and manage pain during and after the surgery.
Overall, the intraoperative period is a critical phase of surgical treatment that requires close collaboration and communication among members of the healthcare team to ensure the best possible outcomes for the patient.
Intraoperative monitoring (IOM) is the practice of using specialized techniques to monitor physiological functions or neural structures in real-time during surgical procedures. The primary goal of IOM is to provide continuous information about the patient's status and the effects of surgery on neurological function, allowing surgeons to make informed decisions and minimize potential risks.
IOM can involve various methods such as:
1. Electrophysiological monitoring: This includes techniques like somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), and electroencephalography (EEG) to assess the integrity of neural pathways and brain function during surgery.
2. Neuromonitoring: Direct electrical stimulation of nerves or spinal cord structures can help identify critical neuroanatomical structures, evaluate their functional status, and guide surgical interventions.
3. Hemodynamic monitoring: Measuring blood pressure, heart rate, cardiac output, and oxygen saturation helps assess the patient's overall physiological status during surgery.
4. Imaging modalities: Intraoperative imaging techniques like ultrasound, computed tomography (CT), or magnetic resonance imaging (MRI) can provide real-time visualization of anatomical structures and surgical progress.
The specific IOM methods employed depend on the type of surgery, patient characteristics, and potential risks involved. Intraoperative monitoring is particularly crucial in procedures where there is a risk of neurological injury, such as spinal cord or brain surgeries, vascular interventions, or tumor resections near critical neural structures.
Anesthetics are medications that are used to block or reduce feelings of pain and sensation, either locally in a specific area of the body or generally throughout the body. They work by depressing the nervous system, interrupting the communication between nerves and the brain. Anesthetics can be administered through various routes such as injection, inhalation, or topical application, depending on the type and the desired effect. There are several classes of anesthetics, including:
1. Local anesthetics: These numb a specific area of the body and are commonly used during minor surgical procedures, dental work, or to relieve pain from injuries. Examples include lidocaine, prilocaine, and bupivacaine.
2. Regional anesthetics: These block nerve impulses in a larger area of the body, such as an arm or leg, and can be used for more extensive surgical procedures. They are often administered through a catheter to provide continuous pain relief over a longer period. Examples include spinal anesthesia, epidural anesthesia, and peripheral nerve blocks.
3. General anesthetics: These cause a state of unconsciousness and are used for major surgical procedures or when the patient needs to be completely immobile during a procedure. They can be administered through inhalation or injection and affect the entire body. Examples include propofol, sevoflurane, and isoflurane.
Anesthetics are typically safe when used appropriately and under medical supervision. However, they can have side effects such as drowsiness, nausea, and respiratory depression. Proper dosing and monitoring by a healthcare professional are essential to minimize the risks associated with anesthesia.
Intraoperative care refers to the medical care and interventions provided to a patient during a surgical procedure. This care is typically administered by a team of healthcare professionals, including anesthesiologists, surgeons, nurses, and other specialists as needed. The goal of intraoperative care is to maintain the patient's physiological stability throughout the surgery, minimize complications, and ensure the best possible outcome.
Intraoperative care may include:
1. Anesthesia management: Administering and monitoring anesthetic drugs to keep the patient unconscious and free from pain during the surgery.
2. Monitoring vital signs: Continuously tracking the patient's heart rate, blood pressure, oxygen saturation, body temperature, and other key physiological parameters to ensure they remain within normal ranges.
3. Fluid and blood product administration: Maintaining adequate intravascular volume and oxygen-carrying capacity through the infusion of fluids and blood products as needed.
4. Intraoperative imaging: Utilizing real-time imaging techniques, such as X-ray, ultrasound, or CT scans, to guide the surgical procedure and ensure accurate placement of implants or other devices.
5. Neuromonitoring: Using electrophysiological methods to monitor the functional integrity of nerves and neural structures during surgery, particularly in procedures involving the brain, spine, or peripheral nerves.
6. Intraoperative medication management: Administering various medications as needed for pain control, infection prophylaxis, or the treatment of medical conditions that may arise during the surgery.
7. Temperature management: Regulating the patient's body temperature to prevent hypothermia or hyperthermia, which can have adverse effects on surgical outcomes and overall patient health.
8. Communication and coordination: Ensuring effective communication among the members of the surgical team to optimize patient care and safety.
"Mental recall," also known as "memory recall," refers to the ability to retrieve or bring information from your memory storage into your conscious mind, so you can think about, use, or apply it. This process involves accessing and retrieving stored memories in response to certain cues or prompts. It is a fundamental cognitive function that allows individuals to remember and recognize people, places, events, facts, and experiences.
In the context of medical terminology, mental recall may be used to assess an individual's cognitive abilities, particularly in relation to memory function. Impairments in memory recall can be indicative of various neurological or psychological conditions, such as dementia, Alzheimer's disease, or amnesia.
Intraoperative complications refer to any unforeseen problems or events that occur during the course of a surgical procedure, once it has begun and before it is completed. These complications can range from minor issues, such as bleeding or an adverse reaction to anesthesia, to major complications that can significantly impact the patient's health and prognosis.
Examples of intraoperative complications include:
1. Bleeding (hemorrhage) - This can occur due to various reasons such as injury to blood vessels or organs during surgery.
2. Infection - Surgical site infections can develop if the surgical area becomes contaminated during the procedure.
3. Anesthesia-related complications - These include adverse reactions to anesthesia, difficulty maintaining the patient's airway, or cardiovascular instability.
4. Organ injury - Accidental damage to surrounding organs can occur during surgery, leading to potential long-term consequences.
5. Equipment failure - Malfunctioning surgical equipment can lead to complications and compromise the safety of the procedure.
6. Allergic reactions - Patients may have allergies to certain medications or materials used during surgery, causing an adverse reaction.
7. Prolonged operative time - Complications may arise if a surgical procedure takes longer than expected, leading to increased risk of infection and other issues.
Intraoperative complications require prompt identification and management by the surgical team to minimize their impact on the patient's health and recovery.