A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK† J.J.

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Presentation transcript:

A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK† J.J. Pandit, T.M. Cook, W.R. Jonker, E. O'Sullivan British Journal of Anaesthesia Volume 110, Issue 4, Pages 501-509 (April 2013) DOI: 10.1093/bja/aet016 Copyright © 2013 The Author(s) Terms and Conditions

Figure 1 Demography of staffing: the number of SAS doctors vs number of consultants in each centre. Each point represents a centre and the line of identity is shown. British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 2 Distribution of mean years' experience of senior staff. British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 3 a) Distribution of accidental awareness during general anaesthesia (AAGA) reports by age. b) Proportions where reports were volunteered by the patient vs established by direct questioning. c) Distribution of reported experiences by phases during anaesthesia and surgery. d) Patients' experiences that included pain or distress, resulting in a formal complaint or in legal proceedings (as a proportion of total cases of AAGA). British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 4 a) Distribution of volunteered reports vs those established by questioning by age. b) Lack of influence of age on when accidental awareness during general anaesthesia (AAGA) was experienced during anaesthesia/surgery. c) Lack of influence of age on pain or distress, or issuing a complaint or legal proceedings. British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 5 Influence of when during anaesthesia/surgery accidental awareness during general anaesthesia was experienced on whether pain or distress resulted, or if a complaint or legal proceedings were issued. British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 6 The influence of denominator value of the number of general anaesthetics administered annually, on the estimated mean incidence (solid blue line) of accidental awareness during general anaesthesia (AAGA) (± 95% Poisson confidence intervals; dashed lines), given our data of 153 instances of AAGA in one year. The incidences are shown as absolute values (left y-axis) and as ratios (right y-axis). The point represents the value assuming the NAP4 estimate of denominator is correct (adjusting for non-responders in this survey)±95% Poisson confidence intervals. British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 7 Distribution of accidental awareness during general anaesthesia cases by centre. The data could be fitted by a Poisson distribution with a covariance r2 >0.997. British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions

Figure 8 Distribution of the number of cases of accidental awareness during general anaesthesia experienced by senior staff in their careers. The spread of values is 0 (0-0 [0-16]), and the data can be fitted by a Poisson distribution with covariance r2>0.997. The x-axis extends to 17 as there was one respondent who had personal experience of 16 cases in his/her career (the data point cannot be seen due to the size of the y-axis scale). British Journal of Anaesthesia 2013 110, 501-509DOI: (10.1093/bja/aet016) Copyright © 2013 The Author(s) Terms and Conditions