Journal Article

  1. Kent CD, Posner KL, Mashour GA, Mincer SL, Bruchas RR, Harvey AE, Domino KB. Patient perspectives on intraoperative awareness with explicit recall: report from a North American anaesthesia awareness registry. British Journal of Anaesthesia 2015 115 (suppl 1): i114-i121 doi: 10.1093/bja/aev211  |  NLM PubMed Link  |  Subjects: Awareness, General Anesthesia, Quality of Care
    This article, using a patient centered approach, characterizes anesthesia awareness events based on the patient’s experiences, and provides their recommendations for health care provider responses to this continuing problem. The authors reviewed self-reported incidences of recall during general anesthesia from the Anesthesia Awareness Registry. Seventy-five percent of patients were dissatisfied with the way their concerns were handled by health care providers. Problems identified by patients included lack of concern, lack of an apology, and no referrals to follow-up counselling. Patients expressed they wanted validation of their experience, explanations, and increased discussion and follow-up. Anesthesia awareness has serious impacts on some patients and more systematic responses and follow-up are needed.
  2. Kent CD, Mashour GA, Metzger NA, Posner KL, & Domino KB. Psychological impact of unexpected explicit recall of events occurring during surgery performed under sedation, regional anaesthesia, and general anaesthesia: data from the Anesthesia Awareness Registry. British Journal of Anaesthesia 110 (3): 381-7, 2013.  |  NLM PubMed Link  |  Full Newsletter or Journal Article  |  Subjects: Awareness
    Anesthetic awareness is a recognized complication of general anesthesia (GA) and is associated with post-traumatic stress disorder (PTSD). This study investigated patient records from the Anesthesia Awareness Registry for psychological sequelae of unexpected explicit recall of events during sedation/regional anesthesia (RA). Patients who experienced unexpected recall under sedation/RA reported comparable distress and persistent psychological sequelae with those who had reported anesthetic awareness under GA. These findings indicate a need for improved physician-patient communication about expectations for recall under sedation/RA.
  3. Kent CD, Domino KB. Awareness: practice, standards, and the law. Best Pract Res Clin Anaesthesiol. 21(3):369-83, 2007.  |  NLM PubMed Link  |  Subjects: Awareness, General Anesthesia
  4. Domino KB, Posner KL, Caplan RA, Cheney FW: Awareness during anesthesia: A closed claims analysis. Anesthesiology 90: 1053-1061, 1999.  |  NLM PubMed Link  |  Subjects: Awareness, General Anesthesia
    Deficiencies of labeling and vigilance were common causes for awake paralysis, whereas recall during general anesthesia represented a more diverse group. Claims for recall during general anesthesia were more likely in females and with nitrous-narcotic-relaxant techniques.



  1. Kent CD, Posner KL, Cheney FW, Lee LA, Domino KB: Update on Closed Claims for Awareness during General Anesthesia. Anesthesiology 105: A1548, 2006.  |  Subjects: Awareness, General Anesthesia  |  PDF icon Click here for .pdf

Closed Claims Bibliography

To access a complete bibliography of peer-reviewed journal articles from the Closed Claims Program, click here; Closed Claims Program Bibliography . You may also request delivery of the bibliography via e-mail, fax or postal mail.

Note to Patients

These studies are primarily designed to aid physicians in improving their clinical practice. We are sorry we cannot address individual patient questions or give medical or legal advice or provide data analysis.