| Author |
Pandit, J. J. Andrade, J. Bogod, D. G. Hitchman, J. M. Jonker, W. R. Lucas, N. Mackay, J. H. Nimmo, A. F. O'Connor, K. O'Sullivan, E. P. Paul, R. G. Palmer, J. H. MacG Plaat, F. Radcliffe, J. J. Sury, M. R. J. Torevell, H. E. Wang, M. Cook, T. M. |
| Description |
Country affiliation: United kingdom Author Affiliation: Pandit JJ ( Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Trust, Oxford, UK jaideep.pandit@dpag.ox.ac.uk.); Andrade J ( Department of Psychology, School of Psychology and Cognition Institute, Plymouth University, Plymouth, UK.); Bogod DG ( Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham, UK.); Hitchman JM ( Member Royal College of Anaesthetists' Lay Committee, London, UK.); Jonker WR ( Department of Anaesthesia, Intensive Care and Pain Medicine, Sligo Regional Hospital, Sligo, Ireland.); Lucas N ( Department of Anaesthesia, Northwick Park Hospital, Harrow, Middlesex, UK.); Mackay JH ( Department of Anaesthesia, Papworth Hospital, Cambridge, UK.); Nimmo AF ( Department of Anaesthesia, Royal Infirmary of Edinburgh, Edinburgh, UK.); O'Connor K ( Bristol School of Anaesthesia, Bristol, UK.); O'Sullivan EP ( Department of Anaesthesia, St James Hospital, Dublin, Ireland.); Paul RG ( Adult Intensive Care Unit, Royal Brompton Hospital, London, UK.); Palmer JH ( Department of Anaesthesia, Salford Royal Hospital, Salford, UK.); Plaat F ( Department of Anaesthesia, Imperial College NHS Trust, London, UK.); Radcliffe JJ ( Department of Neuroanaesthesia, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.); Sury MR ( Department of Anaesthesia, Great Ormond Street Hospital, London, UK.); Torevell HE ( Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK.); Wang M ( Department of Clinical Psychology, University of Leicester, Leicester, UK.); Cook TM ( Department of Anaesthesia and Intensive Care Medicine, Royal United Hospital, Bath, UK.) |
| Abstract |
BACKGROUND: Accidental awareness during general anaesthesia (AAGA) with recall is a potentially distressing complication of general anaesthesia that can lead to psychological harm. The 5th National Audit Project (NAP5) was designed to investigate the reported incidence, predisposing factors, causality, and impact of accidental awareness. METHODS: A nationwide network of local co-ordinators across all the UK and Irish public hospitals reported all new patient reports of accidental awareness to a central database, using a system of monthly anonymized reporting over a calendar year. The database collected the details of the reported event, anaesthetic and surgical technique, and any sequelae. These reports were categorized into main types by a multidisciplinary panel, using a formalized process of analysis. RESULTS: The main categories of accidental awareness were: certain or probable; possible; during sedation; on or from the intensive care unit; could not be determined; unlikely; drug errors; and statement only. The degree of evidence to support the categorization was also defined for each report. Patient experience and sequelae were categorized using current tools or modifications of such. CONCLUSIONS: The NAP5 methodology may be used to assess new reports of AAGA in a standardized manner, especially for the development of an ongoing database of case reporting. This paper is a shortened version describing the protocols, methods, and data analysis from NAP5--the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home. |
