Evaluation of awareness and recall in rhinoplasty operation with local anesthesia and IV sedation

Awareness means patients feeling of pain or other surgical stimulus under anesthesia that may be with or without recall. Awareness under anesthesia and recall can result in traumatic psychological sequel and some patients considered awareness under anesthesia as the worst hospital experience. The aim of this study was to evaluate awareness under anesthesia and its recall after operation. This is an interventional prospective clinical trial study on 52 case of rhinoplasty operation with local anesthesia and IV sedation. Frequncy of recall and awareness were compared in two groups of propofol and midazolam. Awareness during three painful and stressful stage, including local injection, osteotomy and during plaster cast was evaluated. Also, They were asked 2 hours and 2 weeks after surgery, if they recall these stages. There was no significant statistical difference between two groups in awareness of different part of operation. But the midazolam cases have significantly less recall (42.3%) than propofol cases (85.2%) (p= 0.001). Surgeon satisfaction in midazolam group was significantly better than propofol group (p= 0.011). Both propofol and midazolam are good drugs for IV sedation, but midazolam provides better amnesia and higher satisfaction of surgeon.