FOR RELEASE: Immediately March 31, 2006

CONTACT: Gina A. Steiner Donna E. Habich (847) 825-5586

 

Pre-surgery Communication Comforts and Empowers Patients

 

CHICAGO — If you are facing the prospect of surgery, the American Society of Anesthesiologists (ASA) wants you to be well-informed about what you may encounter before, during and after the operation.

In-depth communication is a key component in reducing anxiety prior to surgery. As a patient, you should discuss with your anesthesiologist your medical history, prior experiences with anesthesia and your anesthesia plan. You should also share any specific concerns you may have and inform your anesthesiologist of all the medications you are taking, including over-the counter products.

In return, patients will be reassured to know that anesthesiologists have all of the education, tools and information to provide state-of-the-art care.

“The prospect of undergoing anesthesia and surgery can be unsettling for patients. We believe that the combination of patient communication and ongoing physician education can help alleviate some of this anxiety,” said ASA President Orin F. Guidry, M.D.

As part of ASA’s on-going effort to provide its member physicians with critical patient safety guidance and information, its latest practice advisory tackles the uncommon phenomenon of “patient awareness” during general anesthesia (sometimes called “anesthesia awareness”).

The ASA document, “Practice Advisory for Intraoperative Awareness and Brain Function Monitoring” appears in the April issue of the journal Anesthesiology < www.anesthesiology.org> and represents the most thorough document to date to assist anesthesiologists and hospitals in minimizing the risk of awareness under general anesthesia. Similar information for clinicians is provided in a joint statement produced by the Royal College of Anesthetists and the Association of Anesthetists of Great Britain and Ireland.

Unintended awareness under general anesthesia is a rare event in which a patient may regain consciousness and have recall of events during surgery. The advisory documents that awareness occurs in 1 to 2 cases per 1,000 surgeries performed under general anesthesia. Episodes of awareness may include hearing sounds and feeling sensations or pain and are more likely to occur in patients whose condition is unstable or during surgery for emergencies or trauma.

Although some awareness cases may be brief and insignificant, others may be much more significant or traumatic for the patient. Some episodes of awareness are not preventable, including cases in which the patient’s health or injury requires lighter anesthesia to keep the patient safe. (Awareness is not an issue for patients who undergo procedures with moderate sedation, regional or local anesthesia, as these patients are expected to be aware during some or all of the procedure.) More information is available for patients on ASA’s Web site at < www.asahq.org/patientEducation/Awarenessbrochure.pdf>

The Practice Advisory makes several recommendations to assist decision-making for patient care with the goal of reducing awareness. These recommendations are summarized in four major areas: preoperative evaluation of the patient’s risk for awareness, use of equipment checklists, monitoring depth of anesthesia and drug selection. The advisory states that patients should be monitored with clinical techniques and conventional monitors such as electrocardiograms, vital signs and gas analyzers. Newer devices called “brain function monitors” may also be used at the discretion of the individual anesthesiologist. The Practice Advisory also recommends that anesthesiologists should continue to treat any patient who reports awareness with compassion and respect, and refer them for counseling as appropriate.“

Anesthesiologists are highly skilled physicians who are trained to apply clinical knowledge and experience to ensure the safest and best quality care for their patients. Our primary role is to make sure that every patient is kept safe and protected from pain and fear during surgery,” said Dr. Guidry.

He added that publication of this advisory further supports ASA’s commitment to leadership in patient safety and in understanding and implementing the use of the latest proven technologies and techniques that advance the society’s patient safety goals. “ASA has been educating its members about awareness for more than a decade through its NEWSLETTER and educational meetings. The advisory builds on this tradition and the Society’s longstanding focus on patient safety,” explained Dr. Guidry. “My view is that one case of preventable awareness is one case too many. This advisory will help our members move closer to this goal.”

Founded in 1905, the American Society of Anesthesiologists is an educational, research and scientific association with 40,000 members organized to raise and maintain the standards of the medical practice of anesthesiology and improve the care of the patient.

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Editor’s Note:

Joint statement from the Royal College of Anesthetists and the Association of Anesthetists of Great Britain and Ireland: < http://www.rcoa.ac.uk/index.asp?PageID=64&NewsID=134>

ASA’s patient education brochure is a joint publication with the American Association of Nurse Anesthetists.