Abstract
Sedation encompasses a continuum from complete unconsciousness to drowsiness and anxiolysis where some awareness might be expected. Most patients undergoing endoscopy sedation expect to be completely unconscious during the procedure and thus have unmet expectations regarding their state of consciousness. This study aimed to evaluate whether endoscopy sedation information sheets reduce the level of concern regarding possible awareness during endoscopy sedation at a major regional hospital. Our findings were that 28.8% of patients who received the endoscopy sedation information sheet (n = 82) were concerned about awareness during the procedure, compared to 36.5% of patients in the control group (n = 105). However, the difference was not statistically significant. We also found that the incidence of awareness was higher (13.9%) in the intervention group compared to 8.8% in the control group but, again, not statistically different. This study allowed us to elucidate the level of concern regarding possible awareness during sedation and the incidence of awareness during endoscopy sedation. This will enable future work investigating the role of endoscopy sedation information methods involving written and video material in assisting pre-procedure patient counselling.
Highlights
Awareness is a complication in patients undergoing general anaesthesia
In a study done by Chatman et al (2013), the majority of patients undergoing colonoscopy interpreted any awareness as a complication related to inadequate sedation/anaesthesia [1]
This study allowed us to elucidate the level of concern regarding possible awareness during sedation and the incidence of awareness during endoscopy sedation
Summary
Awareness is a complication in patients undergoing general anaesthesia. sedation encompasses a continuum from complete unconsciousness to drowsiness and anxiolysis where some awareness might be expected. In Australia, most patients undergoing endoscopy sedation expect to be completely unconscious during the procedure. A similar study found that patients undergoing sedation have unmet expectations regarding their state of consciousness and misinterpret the perception of any sensory stimuli beyond unconsciousness as unintended intraoperative awareness and recall [2]. As the use of sedation for procedures like endoscopy is common, the absolute number of patients who experience awareness will likely be noteworthy [5]. This highlights the importance of anaesthesia providers clearly setting appropriate expectations with preoperative information, as the explicit discussion of awareness reduces, rather than increases, patients’ level of concern [1]
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