Incidence of Awareness with Recall under General Anesthesia in Rural India: An Observational Study

CONTEXT: Awareness under anesthesia is a rare but extremely unpleasant phenomenon. There are very few studies in the developing world and none from rural areas where incidence of intraoperative awareness may be higher due to increased patient load, limited patient knowledge and lack of trained hospital staff, reliance on older, cheaper but less effective drugs, and lack of proper equipment both for providing anesthesia, as well as monitoring the patient. AIMS: To assess the incidence of intraoperative awareness during general anesthesia among patients in rural India and any factors associated with the same. SETTINGS AND DESIGN: Prospective, nonrandomized, observational study. SUBJECTS AND METHODS: Patients undergoing elective surgical procedures in various specialties under general anesthesia from over a period of 1 year were considered for this study. Approximately, after 1 h of arrival in postanaesthesia care unit, anesthesiologist (not involved in administering anesthesia) assessed intraoperative awareness using a modified form of Brice questionnaire. STATISTICAL ANALYSIS USED: Data were collected on a Microsoft Excel(®) sheet and analyzed using Statistical Package for the Social Sciences(®) version 23 (SPSS Inc., Chicago, IL, USA) for windows. RESULTS: A total of 896 patients completed the questionnaire. Postoperatively, in response to the questionnaire, seven patients reported to have remembered something under anesthesia. Out of these, three patients described events that were confirmed by operation theater staff to have occurred whereas they were under anesthesia. CONCLUSIONS: Incidence of definite awareness under anesthesia with postoperative recall was found to be 0.33% (three patients out of total 896) in our study.