Awareness is a rare but typical complication during general anesthesia, with a reported incidence of 0.1- 0.2% to 1% (high risk patients) in adults and probably much higher in children with 0.2 -1.2%. Awareness is defined as consciousness during general anesthesia with explicit (conscious) recall of memories.Wakefulness during anesthesia can meet DSM-IV criteria of trauma. Significant long-term psychological sequelae (e.g. post-traumatic stress disorder) may occur.Recommendations of the German Society of Anesthesiologists have been developed according to the ASA Task Force for intraoperative awareness and brain function monitoring.The article focuses on risk factors and sequelae of awareness, explains the options for detection of intraoperative wakefulness and postoperative memories and makes recommendations for prevention and handling of awareness.
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