Lennmarken Claes, Sydsjo Gunilla
Department of Anaesthesia and Intensive Care, University Hospital, S-581 85 Linköping, Sweden.
Best Pract Res Clin Anaesthesiol. 2007 Sep;21(3):357-67. doi: 10.1016/j.bpa.2007.04.005.
Intraoperative awareness with subsequent recall is a rare but serious complication with an incidence of 0.1-0.2%. In approximately one third of the patients who have experienced awareness, late severe psychiatric sequelae may develop. The psychiatric symptoms in these patients fulfil the diagnostic criteria for post traumatic stress disorder. To prevent awareness as a negative outcome after anaesthesia, a thorough perioperative management of anaesthesia is necessary. The definite risk for post traumatic stress disorder following awareness indicates the necessity of postoperative clinical routines to identify awareness patients. The problem must be acknowledged. Professional psychiatric assessment and follow up should constitute standard practice. The treatments of choice are Eye Movement Desensitisation Reprocessing and Cognitive Behaviour Therapy.
术中知晓并伴有随后的回忆是一种罕见但严重的并发症，发生率为0.1 - 0.2%。在经历过知晓的患者中，约三分之一可能会出现晚期严重的精神后遗症。这些患者的精神症状符合创伤后应激障碍的诊断标准。为防止麻醉后出现知晓这一不良后果，必须进行全面的围手术期麻醉管理。知晓后发生创伤后应激障碍的确切风险表明，术后临床常规流程对于识别知晓患者很有必要。必须认识到这个问题。专业的精神科评估和随访应成为标准做法。首选的治疗方法是眼动脱敏再处理疗法和认知行为疗法。
