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New standards adopted for preventing patients from awakening during surgery

Ambulatory Safety Monitor, October 27, 2005

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The American Society of Anesthesiologists (ASA) have approved their first-ever standards to assist in the prevention of patient awareness while under general anesthesia, according to the Associated Press (AP) and a statement issued by the ASA.

In the final report from the ASA's Task Force on Intraoperative awareness, the task force made several recommendations for monitoring patients.

It states that physicians should rely on "multiple modalities, including clinical techniques (e.g., checking for clinical signs such as purposeful or reflex movement) and conventional monitoring systems (e.g., electrocardiograms, blood pressure monitors, heart-rate monitors, end-tidal anesthetic analyzers and capnographs)," according to the ASA's statement.

It also states that "the decision to use a brain function monitor should be made on a case-by-case basis by the individual practitioner for selected patients." However, the ASA did not offer its support for the use of devices intended to monitor patient awareness.

"The most important monitor in the operating room is the anesthesiologist, who has 12 years of medical training and a wealth of experience to draw on when deciding what is appropriate for each individual patient," said Orin Guidry, MD, the newly installed ASA president.

Although the frequency of intraoperative awareness has only been reported as one to two cases per 1,000 surgeries under general anesthesia, the issue became more prominent with press coverage of several lawsuits followed by patients and urging by the Joint Commission on Accreditation of Healthcare Organizations for hospitals to more closely monitor the problem.

More information about patient awareness under anesthesia is available by clicking here.

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