Kole T E
AANA J. 1993 Dec;61(6):571-7.
The problems of intraoperative learning and awareness during surgery have consequences for both the patient and the medical team. With or without recall, the patient can suffer severe emotional trauma that may result in psychological damage. Successful litigation against the anesthesia professional has been increasing in numbers as failure to provide adequate anesthesia can be considered a breach of the unwritten contract between patient and anesthetist. Balanced anesthesia and its use of muscle relaxants can mask indicators of anesthesia depth such as movement or lacrimation. To date, means of monitoring real-time levels of intravenous agents have not yet been fully tested and proven. Therefore, monitoring minimum alveolar concentrations of inhaled anesthetics may be the best currently available method of ensuring anesthetic depth. Investigations comparing the correlation between nitrous oxide and isoflurane minimum alveolar concentrations and anesthetic depth have indicated specific levels at which intraoperative learning ceases to occur.
手术过程中的术中知晓和学习问题对患者和医疗团队都会产生影响。无论患者是否有回忆，都可能遭受严重的情感创伤，进而可能导致心理损伤。由于未能提供充分的麻醉可被视为违反患者与麻醉师之间的不成文契约，针对麻醉专业人员的成功诉讼数量一直在增加。平衡麻醉及其对肌肉松弛剂的使用可能会掩盖麻醉深度的指标，如运动或流泪。迄今为止，静脉麻醉剂实时水平的监测方法尚未得到充分测试和验证。因此，监测吸入麻醉剂的最低肺泡浓度可能是目前确保麻醉深度的最佳可用方法。比较氧化亚氮和异氟烷最低肺泡浓度与麻醉深度之间相关性的研究表明了术中知晓不再发生的特定水平。
