Cargando…

The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia

BACKGROUND: The incidence of postoperative recall under total intravenous anesthesia (TIVA) is not yet fully established. Avoidance of inhalational agent is a known risk factor for awareness. In addition, lack of reliable technique to monitor drug concentration needed for adequate depth of anesthesi...

Descripción completa

Detalles Bibliográficos
Autores principales: Parate, Leena Harshad, Kaur, Navdeep, Iyer, Sadasivan S, Geetha, C. R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916141/
https://www.ncbi.nlm.nih.gov/pubmed/35281356
http://dx.doi.org/10.4103/aer.aer_126_21
_version_ 1784668223503859712
author Parate, Leena Harshad
Kaur, Navdeep
Iyer, Sadasivan S
Geetha, C. R.
author_facet Parate, Leena Harshad
Kaur, Navdeep
Iyer, Sadasivan S
Geetha, C. R.
author_sort Parate, Leena Harshad
collection PubMed
description BACKGROUND: The incidence of postoperative recall under total intravenous anesthesia (TIVA) is not yet fully established. Avoidance of inhalational agent is a known risk factor for awareness. In addition, lack of reliable technique to monitor drug concentration needed for adequate depth of anesthesia makes TIVA challenging. Hence, we intend to evaluate our standard anesthesia practice for postoperative recall. METHODOLOGY: This questionnaire-based observational study was done over the period of 2 years. We enrolled 1080 adult (American Society of Anesthesiologists physical status Class I or II) patients undergoing TIVA for Endoscopic retrograde cholangiopancreatography (ERCP). All patients received fentanyl, midazolam and propofol-based anesthesia. Manual boluses of propofol were given to achieve adequate sedation. (Ramsay sedation scale of 5) in accordance with clinical signs as judged by the primary anesthesiologist. Postoperatively within 12–24 h, patients were assessed for recall using Brice questionnaire. Primary outcome was number of patients reporting postoperative recall in the Brice interview. Secondary outcome was the incidence of dreaming. RESULTS: On postoperative interview, none of the patients reported awareness. 12.5% of patients had dreams which were pleasant. None of the dreams was unpleasant. The worst thing about surgery was pain. CONCLUSION: Our study suggests that if adequate doses of propofol are adhered to and necessary action is taken against responses indicating wakefulness, postoperative recall under TIVA is an uncommon occurrence.
format Online
Article
Text
id pubmed-8916141
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Wolters Kluwer - Medknow
record_format MEDLINE/PubMed
spelling pubmed-89161412022-03-12 The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia Parate, Leena Harshad Kaur, Navdeep Iyer, Sadasivan S Geetha, C. R. Anesth Essays Res Original Article BACKGROUND: The incidence of postoperative recall under total intravenous anesthesia (TIVA) is not yet fully established. Avoidance of inhalational agent is a known risk factor for awareness. In addition, lack of reliable technique to monitor drug concentration needed for adequate depth of anesthesia makes TIVA challenging. Hence, we intend to evaluate our standard anesthesia practice for postoperative recall. METHODOLOGY: This questionnaire-based observational study was done over the period of 2 years. We enrolled 1080 adult (American Society of Anesthesiologists physical status Class I or II) patients undergoing TIVA for Endoscopic retrograde cholangiopancreatography (ERCP). All patients received fentanyl, midazolam and propofol-based anesthesia. Manual boluses of propofol were given to achieve adequate sedation. (Ramsay sedation scale of 5) in accordance with clinical signs as judged by the primary anesthesiologist. Postoperatively within 12–24 h, patients were assessed for recall using Brice questionnaire. Primary outcome was number of patients reporting postoperative recall in the Brice interview. Secondary outcome was the incidence of dreaming. RESULTS: On postoperative interview, none of the patients reported awareness. 12.5% of patients had dreams which were pleasant. None of the dreams was unpleasant. The worst thing about surgery was pain. CONCLUSION: Our study suggests that if adequate doses of propofol are adhered to and necessary action is taken against responses indicating wakefulness, postoperative recall under TIVA is an uncommon occurrence. Wolters Kluwer - Medknow 2021 2022-02-07 /pmc/articles/PMC8916141/ /pubmed/35281356 http://dx.doi.org/10.4103/aer.aer_126_21 Text en Copyright: © 2022 Anesthesia: Essays and Researches https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Parate, Leena Harshad
Kaur, Navdeep
Iyer, Sadasivan S
Geetha, C. R.
The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
title The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
title_full The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
title_fullStr The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
title_full_unstemmed The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
title_short The Study of Postoperative Recall in Patients under Total Intravenous Anesthesia
title_sort study of postoperative recall in patients under total intravenous anesthesia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8916141/
https://www.ncbi.nlm.nih.gov/pubmed/35281356
http://dx.doi.org/10.4103/aer.aer_126_21
work_keys_str_mv AT parateleenaharshad thestudyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT kaurnavdeep thestudyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT iyersadasivans thestudyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT geethacr thestudyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT parateleenaharshad studyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT kaurnavdeep studyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT iyersadasivans studyofpostoperativerecallinpatientsundertotalintravenousanesthesia
AT geethacr studyofpostoperativerecallinpatientsundertotalintravenousanesthesia