Assessment of Incidence and Associated Risk Factors of Awareness With Recall Under General Anesthesia in Non-cardiac and Non-obstetric Patients in Tikur Anbessa Specialized Hospital From May to October 2021, Addis Ababa, Ethiopia

Abstract

<title>Abstract</title> <bold>Introduction:</bold> General anesthesia involves administering drugs to induce hypnosis, amnesia, and stress suppression during surgery. Anesthesia awareness, an unintended event where patients recall experiences during anesthesia, can lead to long-term psychological effects. <bold>Objective: </bold>This study evaluated the incidence and risk factors associated with awareness under general anesthesia among non-cardiac and non-obstetric patients at Tikur Anbesa Specialized Hospital (TASH), Addis Ababa, Ethiopia, from May to October 2021. <bold>Methodology:</bold> A prospective cross-sectional study was conducted at TASH using the modified Brice questionnaire and Aldrete score to assess intra-operative awareness and wakefulness. Systematic random sampling was used to select patients assessed in the Post-Anesthesia Care Unit (PACU) and ward. Data were analyzed using SPSS version 25, and logistic regression was used to determine variable associations (p &lt; 0.05). <bold>Results:</bold> The study included 354 patients (response rate: 96.4%); 58.7% were male, and 41.5% were female, with a mean age of 39.3 years. The incidence of awareness with recall was 11.7%, while dreaming occurred in 9.1% of patients. Awareness was significantly associated with muscle relaxants (OR 2.793, 95% CI 1.872-1.948, p = 0.003). Dreaming was more common in females. <bold>Conclusions:</bold> The incidence of awareness was higher than in many global studies, with consistent risk factors, particularly the use of muscle relaxants. Dreaming was more common among females. <bold>Recommendations:</bold> Anesthesia providers should monitor intra-operative awareness, manage muscle relaxant dosages, and maintain anesthesia equipment, including gas and depth monitors