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Oavsiktlig vakenhet under operation - Hur kan riskerna minskas?
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
2013 (Swedish)Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund:

Awareness definieras som när en patient i generell anestesi i efterhand kan minnas händelser eller ha förnimmelser från en operation då han eller hon borde varit medvetslös. Det är en allvarlig anestesiologisk komplikation som kan leda till posttraumatiskt stressyndrom. Av de patienter som genomgår kirurgiska ingrepp i generell anestesi drabbas cirka 0,1 - 0,2 %. Den vanligaste orsaken till awareness är ytlig anestesi, vilket hos särskilda riskpatienter ibland kan vara svårt att förebygga med endast traditionell övervakning. Det finns därför ytterligare metoder att tillgå. Syfte: Denna litteraturstudie syftade till att undersöka om man med vissa läkemedel, mätmetoder eller andra interventioner kan minska risken för intraoperativ awareness. Metod: Studien genomfördes via artikelsökningar i databaserna PubMed, Cinahl och SveMED+. Efter kvalitetsbedömning och analys inkluderades 20 artiklar i studien. Resultat: Inkluderade artiklar delades in i fyra kategorier för en bättre översikt. Dessa var läkemedels- och anestesiformsrelaterade metoder, EEG-metoder, EEG-metoder kontra traditionell övervakning samt övriga metoder. Resultatet visade att det fanns många metoder att tillgå och att det råder delade meningar om dess effektivitet. Slutsats: De metoder som används har en viss felmarginal och ingen av dem är så effektiv att de kan användas som enda hjälpmedel för att förebygga awareness. EEG-mätningar kan dock vara ett effektivt tillägg till den traditionella övervakningen.

Abstract [en]

Background:

Awareness defines as when a patient undergoing surgery in general anaesthesia can remember events or have sensations allthough he or she should have been uncouncious. It is a very serious complication of anesthesiology that can lead to posttraumatic stress syndrome. Approximately 0,1 – 0,2 % of all patients undergoing surgery in general anesthesia is suffering from intraoperative awareness. The most common reason is light anesthesia which, especially on patients at risk, sometimes can be hard to prevent with only the traditional monitoring at hand. Thereby further interventions are also available. Aim: The aim of this literature review was to examine if the risk for intraoperative awareness can be decreased with the use of certain drugs, measurements or other interventions. Method: This study was performed through search of literature in databases PubMed, Cinahl and SveMED+. After analyze and evaluation regarding quality, 20 articles was included in the study. Results: The included articles were divided into four categories for a better overview. These were drugs- and anesthesiology methods, EEG-methods, EEG-methods compared with traditional monitoring and other methods. The results showed that there are many methods available and that there are mixed opinions of their efficiency. Conclusion: The used methods have a margin of error and none of them are so effective that they can be used as a single method to prevent awareness. EEG-measurements can however be an effective add to the traditional monitoring.

Place, publisher, year, edition, pages
2013. , 38 p.
Keyword [en]
Anaesthesia, explicit recall, implicit recall, intraoperative awareness, literature review
Keyword [sv]
Anestesi, explicit recall, implicit recall, intraoperativ awareness, litteraturstudie
National Category
Anesthesiology and Intensive Care
Identifiers
URN: urn:nbn:se:miun:diva-19178Local ID: 139OAI: oai:DiVA.org:miun-19178DiVA: diva2:627518
Educational program
Emergency Care Specialist Nursing with focus on Anaestetic VANIA 60 higher education credits
Supervisors
Examiners
Available from: 2013-07-02 Created: 2013-06-11 Last updated: 2013-07-02Bibliographically approved

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Oavsiktlig vakenhet under operation - Hur kan riskerna minskas?(451 kB)477 downloads
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Department of Health SciencesDepartment of Health Sciences
Anesthesiology and Intensive Care

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