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The clinical problem selected is awareness during anesthesia in the operation room (OR). Cardinale et al. (2019) state that one of the unforeseeable problems when performing surgical operations is unintended awareness during general anesthesia (UAGA), which is the maintenance of consciousness and explicit recollection while undergoing treatment modalities that should erase both. These criteria are particularly beneficial when the anesthesia provider can confirm the actual events the patient recalls or witnesses accurate patient displays of meaningful involvement with their surroundings. The use of neuromuscular blocking agents (NMBs), emergency procedures, obstetric and cardiothoracic surgery, obesity, age, and prolonged operating time are all factors that substantially enhance the likelihood of intraoperative awareness (Cardinale et al., 2019, p. 98). A patient may become conscious or aware in just one or two out of every thousand medical operations utilizing general anesthesia (American Society of Anesthesiologists, n.d.). While this complication is uncommon, the clinical symptoms and possibly severe psychological consequences necessitate a detailed understanding of the occurrence (Cascella, 2020). Hence, avoiding emerging consciousness episodes is vital for the therapeutic relevance of the problem in this period of anesthesia and statistical data.
It is critical to research feasible strategies to lower the patients chance of becoming conscious during anesthesia. According to Cascella et al. (2020), there are two types of prophylactic techniques for preventing awareness: preoperative control and intraoperative management. Preoperative stage techniques include identifying at-risk individuals, correcting multiple risk factors, and inspecting anesthetic apparatus and tools. Intraoperative management interventions include neuromuscular monitoring, maintaining a suitable anesthetic state until successful recovery of the neuromuscular block, cautious dosage control of neuromuscular blocking medicines, and brain monitoring devices. The research synthesis is needed since it provides a crucial field of examination that intersects study areas in general anesthetic research and neurology (Cascella, 2020). Mechanisms of anesthesia and the effects of anesthetics on awareness and memory are appealing areas for future research into the biological neural network. The answerable (PICOT) question is In cases of patients awareness during anesthesia in the OR, how effective is neuromuscular monitoring compared to brain monitoring devices in preventing UAGA during the intraoperative time?
References
American Society of Anesthesiologists. (n.d.). Anesthesia awareness (waking up) during surgery. Web.
Cardinale, J.P., Gillespie, N., & Germond, L. (2019). Complications of general anesthesia. In C. J. Fox III, E. Cornett, & G. Ghali (Eds.). Catastrophic perioperative complications and management. (pp. 95-103). Springer. Web.
Cascella, M. (2020). The challenge of accidental awareness during general anesthesia. In M. Cascella (Eds.) General anesthesia research. (pp. 1-33). Humana. Web.
Cascella, M., Bimonte, S., & Amruthraj, N. J. (2020). Awareness during emergence from anesthesia: Features and future research directions. World Journal of Clinical Cases, 8(2), 245254. Web.
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