Prognostic factors of intraoperative awakening
Keywords:
Factores de riesgo, Despertar intraoperatorio, Anestesia, Intubación, Edad.Abstract
Introduction: Awakening during anesthesia, with intraoperative memory, occurs when the patient is able to process information and emit specific responses to various stimuli.
Objective: To determine the prognostic risk factors related to the occurrence of intraoperative awakening in patients scheduled for major elective surgery.
Methods: A prospective, analytical, observational, case-control, observational study was carried out in patients belonging to the seven municipalities of the Cauto region announced for major elective surgery at the Carlos Manuel de Céspedes provincial hospital of Bayamo-Granma, Cuba during the period from 2018 to 2021. The universe consisted of 188 patients. We worked with 100% of the population. Descriptive statistics were used for data analysis by calculating absolute and relative percentage frequencies.
Results: Age 65 years or older (OR 7.45; p = 0, 4329) and difficult intubation (OR 61.00; p = 0, 4918) were the surgical risk factors associated with the prognosis of intraoperative awakening.
Conclusions: Ages over or equal to 65 years old, difficult intubation, chronic alcohol intake, surgery lasting more than four hours are factors that increase the risk of suffering this event, which is a problem of special interest for anesthesiologists, due to its sequels and medical-legal complications.
Key words: risk factors; intraoperative awakening; anesthesia; intubation; age.
Downloads
References
1. Vinueza Andrade MC, Acosta Núñez JM, Rojas Bodero WM, Paredes Fernández VR, Pedroza XJ, Murillo Leiton JE. Factores de riesgo en anestesia y retardo en el despertar. Rev UNIANDES Ciencias de la Salud. 2023 [acceso 18/08/2024]6(1):1260-79. Disponible en: https://revista.uniandes.edu.ec/ojs/index.php/RUCSALUD/article/view/2707/3574
2. Vázquez Morales KG. Frecuencia de Despertar Intraoperatorio en pacientes mayores de 18 años, mediante evaluación de recuerdos explícitos en el postoperatorio inmediato, mediato y tardío, sometidos a Anestesia General en el Hospital Central Dr. Ignacio Morones Prieto. Universidad autónoma de San Luis Potosí. Facultad de Medicina. Hospital Central DR. Ignacio Morones Prieto. [Tesis]. 2023 [acceso 18/08/2024]. Disponible en: https://repositorioinstitucional.uaslp.mx/xmlui/bitstream/handle/i/8143/TesisE.FM.2023.Frecuencia.V%25C3%25A1zquez.pdf
3. Benítez Rojas L, Pérez Zayas L. Índice biespectral como evaluación del nivel de conciencia y profundidad anestésica. EsTuSalud. 2024 [acceso 18/08/2024];6(1). Disponible en: https://revestusalud.sld.cu/index.php/estusalud/article/view/381
4. Cortés Barenque MF, Athié García JM, Morales Gámez JL, Alva Arroyo NV, Saucedo Moreno EM. Uso de la monitorización de profundidad anestésica. Acta Méd. Grupo Ángeles. 2021 [acceso 18/08/2024];19(2):190-4. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1870-72032021000200190&lng=es
5. Páez Calvopiña DC, Cueva Figueroa AM, Navarrete Guevara PE, Zurita Fuentes SD. Índice biespectral en anestesiología: aplicaciones clínicas y utilidad en el monitoreo de la profundidad anestésica. Rev RECIMUNDO. 2023. [acceso 18/08/2024]:746-54. Disponible en: https://recimundo.com/index.php/es/article/view/2016
6. Ordoñez Castro AE. Factores asociados al despertar intraoperatorio. Revisión sistemática. Universidad de Cuenca-Facultad de Ciencias Médicas. [Tesis]. 2022 [acceso 19/08/2024]. Disponible en: https://dspace.ucuenca.edu.ec/bitstream/123456789/38548/1/Trabajo%20de%20titulaci%C3%B3n.pdf
7. Rimbert S, Schmartz D, Bougrain L, Meistelman C, Baumann C, Guerci P. MOTANA: study protocol to investigate motor cerebral activity during a propofol sedation. Trials. 2019;20(1):534. DOI: https://doi.org/10.1186/s13063-019-3596-9
8. Lee A, Redding A, Tjia I, Rana S, Heitmiller E. Self-reported awareness during general anesthesia in pediatric patients: A study from Wake Up Safe. Paediatr Anaesth. 2021;31(6):676-85. DOI: https://doi.org/10.1111/pan.14176
9. Akavipat P, Eiamcharoenwit J, Punjasawadwong Y, Pitimana Aree S, Sriraj W, Laosuwan P, et al. Unintended intraoperative awareness: An analysis of Perioperative Anesthetic Adverse Events in Thailand (PAAd Thai). Int J Risk Saf Med. 2021;32(2):123-32. DOI: https://doi.org/10.3233/JRS-200023
10. Tara M J, Moyer JR. Preoperative evaluation and management. In: C linical Anesthesia. 5th ed. Lippincott Williams & Wilkins; 2006.
11. Asociación Médica Mundial. Declaración de Helsinki de la AMM - Principios éticos para las investigaciones médicas en seres humanos. Universidad de Navarra. Centro de Documentación de Bioética; 2013 [acceso 21/02/2019]. Disponible en: http://www.redsamid.net/archivos/201606/2013-declaracion-helsinki-brasil.pdf?1
12. Oliveros H, Ríos F, Botero-Rosas DA, Quiroga SC, Cifuentes FC, Rodríguez GA, et al. Variability of anesthetic depth in total intravenous anesthesia vs balanced anesthesia using entropy indices: a randomized, crossover, controlled clinical trial. Colombian Journal of Anesthesiology. 2020 [acceso 19/08/2024];48:111-7. Disponible en: http://links.lww.com/RCA/A931
13. Cascella M, Viscardi D, Schiavone V, Mehrabmi F, Muzio M, Forte C, et al. A 7-Year Retrospective Multisource Analysis on the Incidence of Anesthesia Awareness With Recall in Cancer Patients: A Chance of Collaboration Between Anesthesiologists and Psycho-Oncologists for Awareness Detection. Medicine (Baltimore). 2016;95(5):e2757. DOI: https://doi.org/10.1097/MD.0000000000002757
14. Singla D, Mangla M. Incidence of Awareness with Recall under General Anesthesia in Rural India: An Observational Study. Anesth Essays Res. 2017;11(2):489-94. DOI: https://doi.org/10.4103/aer.AER_44_17
15. Sanders R, Gaskell A, Raz A, Winders J, Stevanovic A, Rossaint R, et al. Incidence of Connected Consciousness after Tracheal Intubation: A Prospective, International, Multicenter Cohort Study of the Isolated Forearm Technique. Anesthesiology. 2017;126(2):214-22. DOI: https://doi.org/10.1097/ALN.0000000000001479
16. Hernández Gómez Y. Incidencia de conciencia transoperatoria en pacientes sometidos a anestesia general. [Tesis]. Ciudad de México: Universidad Nacional Autónoma de México. Facultad de Medicina, 2023 [acceso 02/01/2025]. Disponible en: https://ru.dgb.unam.mx/bitstream/20.500.14330/TES01000846966/3/0846966.pdf
17. Zhang G, Pan B, Tan D, Ling Y. Factores de riesgo de recuperación tardía de la anestesia general en pacientes sometidos a cirugía biliar radical: ¿qué podemos prevenir? Medicine. 2021;100(32):e26773. DOI: https://doi.org/10.1097/MD.0000000000026773
18. Flores Ballestas JE. Incidencia de despertar intraoperatorio y frecuencia de factores de riesgo en pacientes bajo anestesia general balanceada en el Hospital Universitario Del Caribe. Universidad de Cartagena [Tesis]. 2016 [acceso 21/08/2024]. Disponible en: https://repositorio.unicartagena.edu.co/bitstream/handle/11227/4281/INFORME%20FINAL%20DESPERTAR%20INTRAOPERATORIO.pdf?sequence=1&isAllowed=y
19. Bayable SD, Amberbir WD, Fetene MB. Delayed awakening and its associated factor following general anesthesia service, 2022: a cross-sectional study. Annals of Medicine and Surgery (2012). 2023;85(9):4321-28. DOI: https://doi.org/10.1097/MS9.0000000000001103
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Alberto Rodríguez Carballo, Giselle Lucila Vázquez Gutiérrez, Julio Roberto Vázquez Palanco, Yunior Meriño Pompa, Sulanys Yainet Naranjo Vázquez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Those authors who have publications with this journal accept the following terms:
- They will retain their copyright and guarantee the journal the right of the first publication of their work.
- All the content of the journal is under a license https://creativecommons.org/licenses/by-nc/4.0/deed.es_ES
- It is recommended to the author to insert their articles in recognized preprints serves and introduce their database in server crated to this end.
Sociedad Cubana de Anestesiología y Reanimación (SCAR) 
