Awareness under anaesthesia is a synonym for inadequate anaesthesia

The incidence of awareness with recall under general anaesthesia has previously been reported to range from 0.2 to 0.4%1,2. Patient movement is an indicator of inadequate anaesthesia but this sign is abolished by the use of muscle relaxants unless the isolated forearm technique is used3,4. However, the use of short acting anaesthetic agents at light planes of anaesthesia to promote speedy recovery, higher patient turnover and earlier same-day discharge increases the risk of patient awareness. Approximately 2% of the ASA Closed Claims Project was awareness under general anaesthesia5.

In Dr Rowan's graphic and disturbing report6 we...