الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Awareness is the unexpected recall by patients of events that occurred during anaesthesia. As many as 1 or 2 in every 1000 patients.
There are certain patient characteristics and surgical factors that increase the risk of awareness. Patient-related factors include age, limited cardiac reserves, drug resistance or substance abuse and a history of difficult intubation or previous episodes of awareness. Certain procedures are cesarean section, cardiac surgery, trauma surgery and procedures for which muscle relaxants are used.
Preoperative consultation may be helpful in identifying patients who will be at risk. Awareness results from the inability to provide adequate depth of anaesthesia.
Standard intraoperative monitoring devices. Unfortunately, episodes of awareness have occurred with no changes in haemodynamic parameters.
The monitoring systems can be divided into 2 broad groups: those that analyze electro encephalographic activity and those that analyze evoked responses to auditory stimuli. Some devices also analyze electromyographic activity recorded from scalp muscles.
If intraoperative awareness does occur, the patient should be assessed, reassured and referred back to the anaesthesiologist for follow-up care. patients should be referred for ongoing supportive care and psychological counseling.
Awareness is serious because of the distress that the patient may experience during the episode itself and because of the long-term complications such as post-traumatic stress disorder syndrome .