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Position Statement
Unintended Awareness Under General Anesthesia (Position Statement)
Last AANA revision: 2022
Our paraphrased summary. The text below is our own condensed phrasing for board review, derived from the AANA Practice Manual document of the same name. The AANA document is the authoritative source — read it on aana.com for legally-binding language.
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.