Unintended Return of Consciousness in a Patient during Surgery and General Anesthesia

We searched PubMed/Medline databases for records including the following phrases “awareness under general anesthesia,” “BIS monitoring,” “BIS monitoring prevents awareness under general anesthesia,” “prevention of awareness during general anesthesia,” and “general anesthesia complications.” The search was limited only to human studies in English and Polish from last 12 years (2004–2016). While searching we typed single keywords, their combinations, and used Boolean operators AND, OR, or both. The number of citations acquired in each search was scanned and reduced using inclusion criteria, which covered surgical patients experiDear Sir, The term “awareness” during anesthesia, as used in the anesthesia literature, means that during a period of intended general anesthesia, the brain is aroused by stimuli that are stored in memory for future explicit recall [1] . Patients who experience awareness will recall such experiences during a state of inadequate anesthesia. Although it is an uncommon phenomenon – occurring in about 0.1–0.2% of cases – it is receiving increased attention from patients, clinicians, and researchers worldwide. Awareness may lead to postoperative sequelae that may persist for varying durations. Late psychological symptoms may lead to a severe and debilitating illness – post-traumatic stress disorder (PTSD) [2, 3] . “In 1998 Carol Weiher of Reston, Virginia was undergoing a surgical removal of her right eye, at some point she became fully aware being able to hear disco music. She also managed to hear ‘cut deeper, pull harder.’ She was not able to scream or move her finger to communicate with doctors because the muscle relaxant she had been administered prevented her from doing any controlled movement. She stated later that she silently prayed, pleaded, cursed and screamed trying to do anything she could but in vain” [4] . The Joint Commission on Accreditation of Hospital Organizations (JCAHO), Received: February 15, 2017 Accepted: March 15, 2017 Published online: April 1, 2017