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Long-Term Psychosocial Outcomes after Intraoperative Awareness with Recall

Laukkala, Tanja MD, PhD*; Ranta, Seppo MD, PhD†‡; Wennervirta, Johanna MD, PhD§; Henriksson, Markus MD, PhD; Suominen, Kirsi MD, PhD; Hynynen, Markku MD, PhD#

doi: 10.1213/ANE.0000000000000257
Patient Safety: Research Report

BACKGROUND: Posttraumatic stress disorder, a common psychiatric disorder in the general population, may follow a traumatic experience of awareness with recall during general anesthesia.

METHODS: We conducted a matched cohort design with 9 subjects after intraoperative awareness with recall during general anesthesia. A psychiatric diagnostic interview and questionnaire were performed on 9 matched controls and 9 subjects, a median of 17.2 years from their documented awareness episode. The subjects and the matched controls completed a battery of questionnaires related to psychosocial well-being, after which they participated in a diagnostic Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I Disorders.

RESULTS: Patients with awareness did not seem to differ from their matched controls in subsequent psychosocial outcome, psychiatric morbidity, or quality of life.

CONCLUSIONS: We found no indication that intraoperative awareness with recall had any deleterious long-term effects on patients’ psychosocial outcome.

From the *Field Medicine Services Unit, Centre for Military Medicine, Helsinki; Datawell Ltd., Espoo; Department of Anesthesiology and Intensive Care Medicine, University of Helsinki; §Department of Intensive Care Medicine, Helsinki University Central Hospital, Meilahti Hospital; Department of Health Care Supervision, National Supervisory Authority for Welfare and Health, and Centre for Military Medicine, Helsinki; City of Helsinki, Health Center, Psychiatry; and #Department of Anesthesiology, Helsinki University Central Hospital, Jorvi Hospital, Espoo, Finland.

Accepted for publication February 18, 2014.

Funding: The study was supported by a research grant from Helsinki University Central Hospital.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Tanja Laukkala, MD, PhD, Field Medicine Services Unit, Centre for Military Medicine, Tukholmankatu 8A, P.O. Box 50, 00301 Helsinki, Finland. Address e-mail to

© 2014 International Anesthesia Research Society