Self-reported awareness during general anesthesia in pediatric patients: A study from Wake Up Safe

Edition: May-June 2021

Lee AC, Redding AT, Tjia I, Rana MS, Heitmiller E. Paediatr Anaesth. 2021;31(6):676-685. doi:10.1111/pan.14176

Study Type: Case Series

Method: Registry review of 10 years

Findings:

14 self-reports of awareness under GA in 555,360 patients aged 5 to 20 years
Overall incidence: 2.52 in 100,000
Cardiac: 20 in 100,000 vs. non-cardiac: 1.34 in 100,000
GI endoscopic procedures: 7.74 in 100,000 vs. non-GI endoscopic procedures: 2.13 in 100,000
Most common recalled event was voices in 7/14 cases (50%).
Procedure specifics recalled in 6/14 cases (43%)
10/14 had NMBs
Nil clear association with TIVA

Commentary:

Awareness under GA is very rare in paediatric anaesthesia (c.f. adult awareness under GA at 1:19,600 [NAP5])
Cardiac and GI endoscopic procedures are more frequently associated with awareness
No anaesthetic technique clearly associated with awareness under GA or its prevention

Reviewed by Dr Philip Cheung