Position Statement

Unintended Awareness Under General Anesthesia (Position Statement)

Last AANA revision: 2022

Awareness with explicit recall during GA is a serious adverse event. Highest risk: cardiac surgery, OB GA, trauma, and any case requiring NMB with light anesthesia. AANA endorses prevention through age-adjusted MAC, end-tidal anesthetic gas monitoring, and consideration of processed EEG (BIS).

Key points

1.Maintain age-adjusted end-tidal MAC ≥ 0.7 when paralyzed
2.Anticipate awareness risk in TIVA + NMB cases
3.Brice questionnaire postoperatively for at-risk cases (cardiac, OB, trauma)
4.Acknowledge + apologize without blame; refer to mental health (PTSD risk > 50% if untreated)
5.Document, disclose, complete QI review

This is an exam-prep summary, not a substitute for the full AANA document. Read the source at aana.com for authoritative wording. Education only.