atient awareness under general anesthesia can have significant psychological consequences for the patient, including post-traumatic stress disorder. Analysis of data from the ASA Closed Claims Project shows that intraoperative awareness associated with general anesthesia accounted for 2 percent of closed anesthesia malpractice claims from 1990-2000.¹ The ASA “Practice Advisory for Intraoperative Awareness and Brain Function Monitoring”² identifies potential patient and procedural risk factors for intraoperative awareness.

The ASA Committee on Professional Liability has formed an Anesthesia Awareness Registry in order to better understand patient expectations and experiences of awareness. The project will provide information on patient perceptions of the problem of anesthesia awareness, including their level of understanding and possible misconceptions. The project also will provide a patient perspective on how anesthesiologists might intervene when a patient thinks he/she may have experienced awareness during general anesthesia.

Figure 1 — Project Web site: www.AwareDB.org

Patients who enroll in the Anesthesia Awareness Registry will complete a survey about their experience and submit copies of their medical records for data abstraction and analysis. Limited funding is available to reimburse patients for the costs of obtaining copies of their medical records. Enrollment packets are available on the project Web site: www.AwareDB.org [Figure 1]. The project Web site also will provide a link to the ASA/American Association of Nurse Anesthetists brochure “Patient Awareness Under General Anesthesia — What Is It?”

All patients volunteering for the Anesthesia Awareness Registry will provide informed consent for participation as approved by the University of Washington Human Subjects Review Committee. All subject recruitment and consent must be conducted by University of Washington research team members. ASA members wishing to provide information to their patients about the project can obtain a patient information sheet about the Anesthesia Awareness Registry at the project Web site. Enrollment packets also are available at www.AwareDB.org. Please contact me at kdomino@u.washington.edu if you have further questions.

References:
1. Kent CD. Liability associated with awareness during anesthesia. ASA Newsl. 2006; 70(6):8-10.
2. American Society of Anesthesiologists Task Force on Intraoperative Awareness: Practice advisory for intraoperative awareness and brain function monitoring. A report by the American Society of Anesthesiologists Task Force on Intraoperative Awareness. Anesthesiology. 2006; 104:847-864.

Karen B. Domino, M.D., M.P.H., is Professor of Anesthesiology, University of Washington School of Medicine, Seattle, Washington.