Osterman J E, van der Kolk B A
Department of Psychiatry, Boston University School of Medicine, Massachusetts 02118, USA.
Gen Hosp Psychiatry. 1998 Sep;20(5):274-81. doi: 10.1016/s0163-8343(98)00035-8.
It has been estimated that approximately 30,000 patients a year suffer awareness or consciousness during anesthesia. This paper reviews existing knowledge of the psychological impact and psychiatric sequelae of awareness during anesthesia. Literature on awareness and memory during anesthesia, traumatic memory, and posttraumatic stress disorder (PTSD) was reviewed using computer searches, books, and referenced articles. Few case reports of awareness have identified the accompanying psychological trauma and resulting PTSD. Five published cases illustrating relevant material were selected for inclusion. Waking up during anesthesia, especially if the patient experienced pain, is a traumatic event which places the patient at risk for developing PTSD. Awareness-induced PTSD must be considered for patients who present for mental health treatment following surgery. The advantages of light anesthesia must be balanced against the risk of awareness-induced PTSD.
据估计，每年约有30000名患者在麻醉期间出现术中知晓或意识存在。本文综述了关于麻醉期间知晓的心理影响和精神后遗症的现有知识。通过计算机检索、书籍和参考文献对有关麻醉期间知晓与记忆、创伤性记忆及创伤后应激障碍（PTSD）的文献进行了综述。很少有术中知晓的病例报告能识别出伴随的心理创伤及由此导致的PTSD。选取了5例已发表的说明相关情况的病例纳入本文。麻醉期间苏醒，尤其是如果患者经历了疼痛，是一个创伤性事件，会使患者有患PTSD的风险。对于术后寻求心理健康治疗的患者，必须考虑麻醉期间知晓引发的PTSD。必须在浅麻醉的益处与麻醉期间知晓引发PTSD的风险之间进行权衡。
