Pilge Stefanie, Schneider Gerhard
Klinik für Anästhesiologie des HELIOS Klinikums Wuppertal, Klinikum der Universität Witten / Herdecke, Germany.
Anasthesiol Intensivmed Notfallmed Schmerzther. 2013 Jan;48(1):48-55; quiz 56. doi: 10.1055/s-0032-1333079. Epub 2013 Jan 30.
Awareness is a rare but typical complication during general anesthesia, with a reported incidence of 0.1- 0.2% to 1% (high risk patients) in adults and probably much higher in children with 0.2 -1.2%. Awareness is defined as consciousness during general anesthesia with explicit (conscious) recall of memories.Wakefulness during anesthesia can meet DSM-IV criteria of trauma. Significant long-term psychological sequelae (e.g. post-traumatic stress disorder) may occur.Recommendations of the German Society of Anesthesiologists have been developed according to the ASA Task Force for intraoperative awareness and brain function monitoring.The article focuses on risk factors and sequelae of awareness, explains the options for detection of intraoperative wakefulness and postoperative memories and makes recommendations for prevention and handling of awareness.
术中知晓是全身麻醉期间一种罕见但典型的并发症,据报道,其在成人中的发生率为0.1% - 0.2%至1%(高危患者),在儿童中可能更高,为0.2% - 1.2%。术中知晓被定义为全身麻醉期间有意识且能明确(有意识地)回忆起记忆。麻醉期间的觉醒可能符合创伤的《精神疾病诊断与统计手册》第四版标准。可能会出现严重的长期心理后遗症(如创伤后应激障碍)。德国麻醉医师协会的建议是根据美国麻醉医师协会术中知晓与脑功能监测特别工作组制定的。本文重点关注术中知晓的危险因素和后遗症,解释检测术中觉醒和术后记忆的方法,并对预防和处理术中知晓提出建议。