Document Type : Original Article
Authors
1 Department of Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Iranian Research Center on Healthy Aging, Sabzevar University of Medical Sciences, Sabzevar, Iran
Abstract
Background: Patients who experience awareness during anesthesia, in addition to the pain they experience during surgery, develop postoperative physical and psychological disorders that can affect the course of their lives. This study aimed to explain the experiences of patients undergoing surgery in the field of awareness under anesthesia.
Methods: The present qualitative research was conducted using conventional content analysis in 2022 in Iran. The present qualitative research was conducted using contract content analysis in 2022 in Iran. Twelve participants were purposefully selected from patients undergoing surgery at Valiasr Hospital in Borujen who had experienced awareness under anesthesia. Data were collected using in-depth semi-structured individual interviews and were analyzed using the Graneheim and Lundman approach. To manage the data, MAXQDA software version 10 was used.
Results: The important experiences of the participants were divided into 1 main category, invisible surgical wound, and 4 subcategories (living with psychological damage, residual fear, physical trauma, and spiritual distress).
Conclusion: Study participants experience physical and psychological trauma during awareness during anesthesia. To prevent many psychological and physical symptoms following the recollection of this phenomenon in individuals, we should first identify these individuals by conducting interviews and asking appropriate questions about the accuracy of this phenomenon in individuals. In the next stage, by examining the physical and psychological symptoms in different periods after the occurrence of the phenomenon and by timely identifying the different symptoms in these people and taking counseling and treatment measures, the severity of the symptoms and their negative effects on people’s daily lives can be prevented.
Keywords
- Bonhomme V, Staquet C, Montupil J, Defresne A, Kirsch M, Martial C, et al. General anesthesia: a probe to explore consciousness. Front Syst Neurosci. 2019;13:36. doi: 10.3389/ fnsys.2019.00036.
- Odor PM, Bampoe S, Lucas DN, Moonesinghe SR, Andrade J, Pandit JJ. Protocol for direct reporting of awareness in maternity patients (DREAMY): a prospective, multicentre cohort study of accidental awareness during general anaesthesia. Int J Obstet Anesth. 2020;42:47-56. doi: 10.1016/j.ijoa.2020.02.004.
- Alonso LM, Solovey G, Yanagawa T, Proekt A, Cecchi GA, Magnasco MO. Single-trial classification of awareness state during anesthesia by measuring critical dynamics of global brain activity. Sci Rep. 2019;9(1):4927. doi: 10.1038/s41598- 019-41345-4.
- Linassi F, Zanatta P, Tellaroli P, Ori C, Carron M. Isolated forearm technique: a meta-analysis of connected consciousness during different general anaesthesia regimens. Br J Anaesth. 2018;121(1):198-209. doi: 10.1016/j.bja.2018.02.019.
- Kim H, Moon JY, Mashour GA, Lee U. Mechanisms of hysteresis in human brain networks during transitions of consciousness and unconsciousness: theoretical principles and empirical evidence. PLoS Comput Biol. 2018;14(8):e1006424. doi: 10.1371/journal.pcbi.1006424.
- Najafi A, Kohan F, Sotoudeh G, Khajavi M, Barkhordari KH. Evaluation of patients’ knowledge about anesthesia and responsibilities of anesthesiologist. J Iran Soc Anaesthesiol Intensive Care. 2004;25(45):57-69. [Persian].
- Lee H, Golkowski D, Jordan D, Berger S, Ilg R, Lee J, et al. Relationship of critical dynamics, functional connectivity, and states of consciousness in large-scale human brain networks. Neuroimage. 2019;188:228-38. doi: 10.1016/j. neuroimage.2018.12.011.
- Koch C, Massimini M, Boly M, Tononi G. Neural correlates of consciousness: progress and problems. Nat Rev Neurosci. 2016;17(5):307-21. doi: 10.1038/nrn.2016.22.
- Sanders RD, Gaskell A, Raz A, Winders J, Stevanovic A, Rossaint R, et al. Incidence of connected consciousness after tracheal intubation: a prospective, international, multicenter cohort study of the isolated forearm technique. Anesthesiology. 2017;126(2):214-22. doi: 10.1097/aln.0000000000001479.
- Radek L, Kallionpää RE, Karvonen M, Scheinin A, Maksimow A, Långsjö J, et al. Dreaming and awareness during dexmedetomidine- and propofol-induced unresponsiveness. Br J Anaesth. 2018;121(1):260-9. doi: 10.1016/j. bja.2018.03.014.
- Tasbihgou SR, Vogels MF, Absalom AR. Accidental awareness during general anaesthesia - a narrative review. Anaesthesia. 2018;73(1):112-22. doi: 10.1111/anae.14124.
- Singla D, Mangla M. Incidence of awareness with recall under general anesthesia in rural India: an observational study. Anesth Essays Res. 2017;11(2):489-94. doi: 10.4103/aer. AER_44_17.
- Malek B, Seghlis R, Dabbagh A. Awareness during anesthesia in elective abdominal surgery in opium abusers. Tehran Univ Med J. 2010;67(10):731-5. [Persian].
- Staquet C, Vanhaudenhuyse A, Bonhomme V. Aware beside an unconscious patient, not the inverse! On the necessity of knowing how anesthesia modulates consciousness. Acta Anaesthesiol Belg. 2018;69(3):137-45.
- Yazdimoghaddam H, Mohamadzadeh Tabrizi Z, Zardosht R. Ethical care: nurses’ experience of moral judgment in intensive care units. J Qual Res Health Sci. 2023;12(1):17-24. doi: 10.34172/jqr.2023.03. [Persian].
- Zardosht R, Ghardashi F, Borzoee F, Akbarzadeh R, Vafi F, Yazdimoghaddam H, et al. Fear of the unknown, anxiety, and social isolation in Iranian patients with COVID-19, the grounded theory. J Educ Health Promot. 2023;12:360. doi: 10.4103/jehp.jehp_861_22.
- Imani B, Bahrami Jalal S. Surgical technologists’ live experiences of professionalization: a phenomenological study. J Qual Res Health Sci. 2022;11(4):231-6. doi: 10.34172/ jqr.2022.11.
- Roshanzadeh M, Jamalinik M, Hasheminik M, Tajabadi A. Stigma of COVID-19: the basic challenge in health economics. Iran Occupational Health. 2020;17(1):137-41. [Persian].
- Roshanzadeh M, Shirvani M, Tajabadi A, Khalilzadeh MH, Mohammadi S. The clinical learning challenge of surgery technologist students: a qualitative content analysis. Payavard Salamat. 2022;16(2):102-12. [Persian].
- Roshanzadeh M, Vanaki Z, Sadooghiasl A, Tajabadi A, Mohammadi S. Explaining courage in ethical decision-making by nursing managers: a qualitative content analysis. J Holist Nurs Midwifery. 2021;31(4):254-62. doi: 10.32598/ jhnm.31.4.2141.
- Messina AG, Wang M, Ward MJ, Wilker CC, Smith BB, Vezina DP, et al. Anaesthetic interventions for prevention of awareness during surgery. Cochrane Database Syst Rev. 2016;10(10):CD007272. doi: 10.1002/14651858.CD007272. pub2.
- Ghaderi F, Akrami N, Namdari K, Abedi A. Life experiences of patients with generalized anxiety disorder (GAD) comorbid with emotional disorders: a qualitative study. J Qual Res Health Sci. 2022;11(1):10-8. doi: 10.22062/jqr.2021.193614.0.
- Yayla F, Askeroğlu A. Experiences of patients undergoing emergency surgery in COVID-19 pandemic: a qualitative study. J Patient Exp. 2022;9:23743735221092602. doi: 10.1177/23743735221092602.
- Kim JH, McMahon BT, Hawley C, Brickham D, Gonzalez R, Lee DH. Psychosocial adaptation to chronic illness and disability: a virtue-based model. J Occup Rehabil. 2016;26(1):45-55. doi: 10.1007/s10926-015-9622-1.
- Samiee Rad F, Kalhor M. An overview of spiritual health in cancer patients. Iran J Psychiatr Nurs. 2019;6(6):82-8. doi: 10.21859/ijpn-060610. [Persian].