Incidence of awareness during general anaesthesia for caesarean delivery general anaesthesia for caesarean delivery: A comparison of three different induction agents using the isolated forearm technique

Abstract

ABSTRACT: The study was undertaken to determine the incidence of awareness and recall in term gravid women during general anaesthesia for elective Caesarian delivery. This was done using observation for signs of "light" anaesthesia and the response to a standardised, pre-recorded verbal command using the isolated forearm technique. These observations were correlated with patient responses to a standardised series of enquires regarding awareness presented during a postoperative interview.

Three groups of patients were studied, with each group being anaesthetised with a different induction agent. The relative incidence of positive finding was determined by comparing results obtained from these three groups. It was found that clinical signs of light anaesthesia and awareness were very common during the fifteen minutes following anaesthetic induction. However, actual recall of intraoperative events did not occur. Hence, the results comfirm previous reports of a high degree of discordance between sign of light anaesthesia and actual awareness. The implication of this finding is that clinical signs of light anaesthesia during Caesarean delivery are nonspecific and have very low predictive value for the actual risk of awareness leading to recall.