The Royal College of Anaesthetists
(RCoA) and the Association of Anaesthetists of Great Britain and Ireland
(AAGBI) published on March 22, 2013, initial findings from a major study which looked
at how many patients experienced accidental awareness during general
anaesthesia.
The survey asked all senior
anaesthetists in NHS hospitals in the UK (more than 80% of whom replied)
to report how many cases of accidental awareness during general
anaesthesia they encountered in 2011. There are three million general
anaesthetics administered each year. Study findings are published in Anaesthesia, and The British Journal of Anaesthesia, the peer-reviewed journals of the AAGBI, and RCoA respectively.
Previous reports have suggested a
surprisingly high incidence of awareness of about one in 500 general
anaesthetics. The current report found it to be much less common in the
UK with one episode known to anaesthetists in every 15,000 general
anaesthetics. The report also reports very low use of brain monitoring
technology: with only 2% of anaesthetists routinely using it.
The survey is part of a major study
called the Fifth National Audit Project (NAP5) taking place over three
years. NAP5 is thought to be the largest study of its kind ever
conducted and is funded entirely by the profession.
Professor Jaideep Pandit, Consultant
Anaesthetist in Oxford and lead author, said, “Anaesthesia is a medical
speciality very much focussed on safety and patient experience. We
identified accidental awareness during anaesthesia as something which
concerns patients and the profession. The profession is therefore
undertaking this major study so that we can better understand the
problem and work to reduce the likelihood of it happening to patients.”
“We are particularly interested in patient experiences of awareness. Although we know that some patients do suffer distress after these episodes, our survey has found that the vast majority of episodes are brief and do not cause pain or distress.”
“Our study will continue to explore
the reasons for the differences between our figures and previous
reports. Anaesthesia in the UK is administered only by trained doctors
and is a consultant-led service. Whether this – or other factors such as
differences in patient sensitivity to anaesthetic drugs or different
detection rates influence the reported numbers – is something we will be
studying in the rest of the project.”
Professor Tim Cook, co-author and a
Consultant Anaesthetist in Bath said, “Risks to patients undergoing
general anaesthesia are very small and have decreased considerably in
the last decades. Anaesthesia doctors in the UK undergo the same level
of training as surgeons and physicians. Of the three million general
anaesthetics administered in the NHS each year, only a very small number
of patients experience awareness during anaesthesia, with the majority
of these occurring before surgery starts or after it finishes.”
“While our findings are generally
reassuring for patients and doctors alike, we recognize that there is
still more work to be done. We are spending the next year studying as
many of the cases as possible to learn more from patients’ experiences.
It is hoped that the findings included in the final report, due out
early 2014, will increase our understanding of accidental awareness
during general anaesthesia so that the anaesthetic profession can
further increase safety for patients.”
“Anaesthetists have always put
patients first and will continue to do so. This study, which comes just
after the publication of the Francis report, shows that anaesthetists
are clearly listening to patients and have acted positively to address a
major patient concern.”
Source: Wiley