Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

General anesthesia (GA) for caesarean section (CS) has distinctive characteristics that may increase
the risk of awareness during GA (AGA).

The aim of this study was to investigate the incidence of unintended awareness during GA (AGA)
in CS.

This cross-sectional descriptive study was performed in Alzahra Hospital in Rasht City, Iran. Eligible women with term pregnancy candidates for CS under GA were enrolled in this survey from May 2018 to August 2021. After delivery, a questionnaire including demographic data and questions related to different stages of anesthesia was completed via a faceto- face interview. The collected data were analyzed using repeated measurement, the Chi-square, Fisher exact, and t-test in SPSS v. 21.

The data from 174 women were analyzed, and 12 (6.9%) experienced AGA. Among them, dreaming and feeling the manipulation of the surgical area (27.8%) were the most common reported awareness states. Body mass index had a significant (P=0.034) relationship with AGA, but age (P=0.843), the level of education (P=0.714), history of anesthesia (P=0.552), 5-minute Apgar score (P=0.49), and surgery time (P=0.686) had no significant relationship with AGA.

The incidence of AGA during CS was almost close to the high limit established by the credible evidence, and a significant number of the women were not in completely acceptable conditions. Therefore, the management of GA for CS should be revised in this academic hospital.