{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:07:07Z","timestamp":1792098427288,"version":"4.4.0"},"reference-count":60,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,12,5]],"date-time":"2017-12-05T00:00:00Z","timestamp":1512432000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness. For example, the Cons\n                    <jats:styled-content style=\"fixed-case\">CIOUS<\/jats:styled-content>\n                    \u20101 study showed an incidence of responsiveness around the time of laryngoscopy of 1:25. On the other hand, the 5th Royal College of Anaesthetists National Audit Project, which reported the largest ever cohort of patients who had experienced accidental awareness, used a system to identify patients who spontaneously self\u2010reported accidental awareness. In this latter study, the incidence of accidental awareness was 1:19,600. In the recently published\n                    <jats:styled-content style=\"fixed-case\">SNAP<\/jats:styled-content>\n                    \u20101 observational study, in which structured postoperative interviews were performed, the incidence was 1:800. In almost all reported cases of intra\u2010operative responsiveness, there was no subsequent explicit recall of intra\u2010operative events. To date, there is no evidence that this occurrence has any psychological consequences. Among patients who experience accidental awareness and can later remember details of their experience, the consequences are better known. In particular, when awareness occurs in a patient who has been given neuromuscular blocking agents, it may result in serious sequelae such as symptoms of post\u2010traumatic stress disorder and a permanent aversion to surgery and anaesthesia, and is feared by patients and anaesthetists. In this article, the published literature on the incidence, consequences and management of accidental awareness under general anaesthesia with subsequent recall will be reviewed.\n                  <\/jats:p>","DOI":"10.1111\/anae.14124","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T16:19:46Z","timestamp":1512749986000},"page":"112-122","source":"Crossref","is-referenced-by-count":74,"title":["Accidental awareness during general anaesthesia \u2013 a narrative review"],"prefix":"10.1111","volume":"73","author":[{"given":"S. R.","family":"Tasbihgou","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University Medical Centre Groningen University of Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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