Awareness and Dreaming During Total Intravenous Anesthesia in Outpatients Undergoing Extracorporeal Shockwave Lithotripsy

NATIONAL KIDNEY AND TRANSPLANT INSTITUTE
Department of Anesthesiology

TITLE: AWARENESS AND DREAMING DURING
TOTAL INTRAVENOUS ANESTHESIA IN OUTPATIENTS UNDERGOING
EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY:
A PRELIMINARY SURVEY

AUTHOR: Xenia P. David, M.D. Senior Resident

CO-INVESTIGATORS: Alexander Bautista, M.D. Junior Resident

Warren Caballa, M.D. Junior Resident

Ronald Torres, M.D. Junior Resident

SUPERVISING INVESTIGATOR: Arnold S. Uy, M.D., D.P.B.A. Consultant NKTI, Department of Anesthesiology

ENDORSED BY: Jaime G. Velasquez, M.D., D.P.B.A Chairman NKTI, Department of Anesthesiology

SPECIALTY/SUBJECT MATTER/CATEGORY OF STUDY: Anesthesia

PRIMARY LOCATION OF THE STUDY: National Kidney and Transplant Institute

FUNDING/SPONSORING AGENCY: National Kidney and Transplant Institute

SUMMARY

The incidence of awareness during anesthesia with postoperative recall is relatively low at 0.13%. However, this may result in posttraumatic stress disorder in the patient, and have in some instances have given rise to litigation. Intraoperative awareness is now a well-recognized complication, and preventing it is one of the anesthesiologist’s top priorities.

The risk of awareness is associated with the use of neuromuscular relaxants, nitrous oxide, and intentionally light anesthesia for cardiac surgeries and emergency operations in trauma patients. Total intravenous anesthesia using the popular anesthetic agent propofol may also result in awareness due to the wide interpatient variability in dosage; the inability to monitor the plasma concentrations of the drug, unlike in inhalational anesthetics; and the agent’s lack of amnestic properties. A large number of patients at this institution undergo propofol anesthesia for extracorporeal shockwave lithotripsy (ESWL), so the potential for awareness during this procedure must not be overlooked.

This

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