The incidence of intra-operative awareness during general anesthesia in China: a multi-center observational study
Article first published online: 3 JUN 2009
© 2009 The Authors. Journal compilation © 2009 The Acta Anaesthesiologica Scandinavica Foundation
Acta Anaesthesiologica Scandinavica
Volume 53, Issue 7, pages 873–882, August 2009
How to Cite
XU, L., WU, A.-S. and YUE, Y. (2009), The incidence of intra-operative awareness during general anesthesia in China: a multi-center observational study. Acta Anaesthesiologica Scandinavica, 53: 873–882. doi: 10.1111/j.1399-6576.2009.02016.x
- Issue published online: 7 JUL 2009
- Article first published online: 3 JUN 2009
- Accepted for publication 7 April 2009
Background: The incidence of awareness in patients undergoing general anesthesia is 0.1–0.2% in Western countries. The medical literatures about awareness during general anesthesia are still rare in China, but some previous studies have reported a higher incidence (1.4–6%) of intra-operative awareness. To find out the reason why the incidence reported in China is much higher than that in Western countries, we performed a prospective, multicenter, non-randomized observational study to determine the true incidence of intra-operative awareness in China.
Methods: This is a prospective, non-randomized descriptive cohort study that was conducted at 25 academic medical centers in China. Eleven thousand one hundred and eighty-five patients were interviewed by research staff for evaluation of awareness at the first and fourth day after general anesthesia with muscle relaxation. An independent blinded committee evaluated the responses and determined whether awareness occurred. Necessary data were collected for a binary logistic regression analysis.
Results: Data from 11,101 patients were presented. Forty-six cases (0.41%) were reported as definite awareness and 47 additional cases (0.41%) as possible awareness. Three hundred and fifty-five patients (3.19%) had dreams during general anesthesia. Awareness was associated with increased American Society of Anesthesiologists (ASA) physical status, a previous anesthesia, and anesthesia methods of total intravenous anesthesia.
Conclusion: The incidence of intra-operative awareness in China is approximately 0.41%, two to three times higher than that widely cited in Western countries. Inappropriately light anesthesia, and the population proportion of surgery and general anesthesia in China may account for the difference. (ClinicalTrials.gov Identifier, NCT00693875.)