Intraoperative awareness with recall during General Anaesthesia in Damascus University Hospitals in Syria

Background: Awareness with recall during general anesthesia is one of the frightening complications of general anesthesia, which indicates the failure of anesthesia. Awareness is an underestimated complication despite the fact that it sometimes carries devastating psychological risks for patients. To our knowledge this is the first research in Syria that reports the incidence of awareness with recall during general anesthesia. Aims: to assess the incidence of awareness with recall during general anesthesia in Damascus University teaching hospitals. Design: Multi-central prospective cohort study. Setting: Three main Teaching Hospitals of Damascus University: Al-Assad, Al-Mowassat & Maternity Hospitals during the time period between January and November 2021. Study Sample: 3500 patients aged ≥ 18 years were included. Results: the incidence of Awareness with recall during general anesthesia in Damascus University Teaching Hospitals was 0.66% in low risk of awareness surgery and 1.8% in high risk of awareness surgeries. The most frequent manifestations of awareness were auditory perceptions, paralysis and pain (100%, 100% & 97.4% respectively). Conclusions: Awareness with recall rate was somehow high in Damascus University Teaching Hospitals in comparison to the figures reported by American and European studies, this difference was especially noted in a low risk of awareness surgery. The rates were similar in the high risk of awareness surgeries. Lack of premedication and low concentration of inhalational agent were the main reasons for awareness.