NEWS
Accidental awareness in obstetric surgery more frequent than expected
Accidental awareness occurs when a patient is temporarily conscious during a general anaesthetic and can remember things that happened during surgery – including feeling pain or being unable to move. A new study published in Anaesthesia shows that 1 in 256 women undergoing pregnancy-related surgery, including Caesarean section, under general anaesthesia experienced awareness – a figure much higher than reported before. A recent national audit into accidental awareness (NAP5) indicated that approximately 1 in every 19,000 patients undergoing general anaesthesia spontaneously reported accidental awareness to medical staff. Although this incidence varied for different types of surgery and patient subgroups, the infrequency of reports was reassuring. Dr. Peter Odor, project lead and consultant anaesthetist at University College Hospital in London, explained: “We identified a complex range of risk factors for awareness, including drug types and variations in practice. Although the incidence of awareness during Caesarean section is much higher than that in the general surgical population, it is important to emphasise that general anaesthesia remains safe and around half the patients that experienced awareness did not find it distressing…Our next steps are to apply the lessons learned from this study to help reduce risk in the future.” Dr. Nuala Lucas, co-author and consultant obstetric anaesthetist at Northwick Park Hospital, Harrow, UK,
Leading experts appointed to NHS Race and Health
added: “This is the biggest ever study of this complication in women and has been able to contribute to our understanding of the condition. We found an association with certain anaesthetic drugs (thiopentone) and muscle relaxants. Factors such as emergency operations out-of-hours (late at night) were also associated with awareness.” To access the study, visit: https:// associationofanaesthetists-publications.
onlinelibrary.wiley.com/doi/10.1111/ anae.15385
Observatory The NHS Race and Health Observatory, supported by NHS England and hosted by the NHS Confederation, has appointed its full board of non-executive directors, bringing in some of the world’s leading experts on health inequalities. Members include Professor Sir Michael Marmot, of the UCL Institute of Health Equity; Professor David Williams, of the Harvard School of Public Health; Dame Donna Kinnair, chief executive and general secretary of the Royal College of Nursing; Professor Kevin Fenton, London regional director for Public Health England; and Dr. Chaand Nagpaul, chair of the council of the British Medical Association. The Observatory will work towards tackling ethnic and racial inequalities in healthcare for patients, communities and the NHS workforce. The Observatory now has a total of 15 board members. It appointed Marie Gabriel CBE as chair and Dr. Habib Naqvi MBE as director last summer.
As COVID-19 infection rates rise and the crisis continues to cast into sharp relief the inequalities that have long affected people from BME backgrounds and communities, the Observatory’s work will continue to be highly relevant.
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