also found that 65% of patients who experienced awareness and recall during general anesthesia did not inform their anesthesiologists about what happened. Inspection of the anesthetic records of awareness cases for relevant parameters such as heart rate, blood pressure, and anesthetic technique has not been helpful in retrospectively explaining why awareness or recall occurred. The effects of adding intravenous agents, such as benzodiazepines, propofol, and opioids, to inhalation anesthetics, as is sometimes done in clinical practice, remain to be studied. Minimal values of 0.8–1.0 minimum alveolar concentration of inhalation anesthetics currently appear acceptable. The precise concentration of anesthetic agent required to guarantee lack of recall is unknown. The most frequently reported postoperative effects were sleep disturbances, dreams and nightmares, flashbacks, and daytime anxiety. It seems that patients particularly recall conversations or remarks that are of a negative nature concerning themselves or their medical conditions. The two most frequent complaints were ability to hear events during surgery and sensations of weakness or paralysis, in addition to the recall of pain, if it was present. Despite the different strategies of patient selection of the two groups, there was close agreement between the results. studied patients who were referred to them by anesthesiologists. Cobcroft and Forsdick described patients who responded to an article published by Forsdick about her own experience of awareness during anesthesia in a lay magazine widely distributed in Australia and New Zealand. studied the consequences of recall of intraoperative events during anesthesia. Recently Cobcroft and Forsdick and Moerman et al. With conflicting reports and contradictory statements being published, we chose to update the reader on this and related subjects with particular emphasis on problems and difficulties in this area, and to provide some comments that we hope will be useful for future studies. We and others thought that with improvement in the quality of work in this area, the issue of whether unconscious retention of intraoperative events is a reliable, replicable phenomenon might be resolved in a few years. In 1992, the issue of preservation of unconscious information-processing capability by the anesthetized patient was debated because of the mixed results of studies at that time. ![]() Since then, there has been a steady flow of publications and two international conferences on the subject one in 1992 in Atlanta, Georgia, and another in 1995 in Rotterdam, the Netherlands. In 1992, we published a review article in Anesthesiology on learning and consciousness during general anesthesia.
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