Preventing and managing awareness during general anesthesia

  • Jelena Berger Klinični oddelek za anesteziologijo in intenzivno terapijo operativnih strok, UKC Ljubljana
  • Polona Mušič Klinični oddelek za anesteziologijo in intenzivno terapijo operativnih strok, UKC Ljubljana
  • Bernarda Logar Zakrajšek SPS Kirurška klinika, UKC Ljubljana
  • Dušan Mekiš Oddelek za anesteziologijo, intenzivno terapijo in terapijo bolečin, UKC Maribor Medicinska fakulteta, Univerza v Mariboru
Keywords: depth of general anesthesia, intraoperative awareness, anesthesia complications, prevention, post-traumatic stress disorder


Background: General anesthesia is a reversible state of a temporary loss of consciousness, analgesia, muscle paralysis, blunted autonomic responses and amnesia. To achieve this, an adequate depth of anesthesia should be maintained throughout the surgery. Awareness is a serious complication of general anesthesia, which occurs when the depth of anesthesia is not appropriate due to various causes.

In this paper the underlying neurobiology of intraoperative awareness is presented, as well as risk factors for awareness and methods for assessing the depth of anesthesia. Possible psychological consequences of awareness and their management are also discussed. At the end, the recommendations for preventing intraoperative awareness are given.

Conclusions: Awareness during general anesthesia may have adverse psychological sequelae in individual patients, therefore guidelines for preventing and managing of intraoperative awareness need to be adopted. In case of a possible awareness, the recommendations for offering a psychological support should also be followed.


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How to Cite
Berger J, Mušič P, Logar Zakrajšek B, Mekiš D. Preventing and managing awareness during general anesthesia. ZdravVestn [Internet]. 1 [cited 18Apr.2019];83(2). Available from: