No evidence of long-term PTSD risk in patients with awareness during surgery

Study shows no increase in post-traumatic symptoms years after 'intraoperative awareness with recall'

2014-06-20

(Press-News.org) June 20, 2014 – Patients with confirmed episodes of awareness during anesthesia and surgery don't seem to be at increased risk of posttraumatic stress disorder (PTSD) or other problems with psychosocial well-being at long-term follow-up, reports a study in Anesthesia & Analgesia.

"We found no indication that intraoperative awareness with recall had any long-term effects on patients' psychosocial outcome," concludes the new research by Dr Tanja Laukkala of the Centre for Military Medicine in Helsinki, Finland. Anesthesiologists "should respond to the findings…with a mixture of cautious optimism coupled with a renewed commitment to the prevention and treatment of PTSD" after intraoperative awareness, according to an editorial by Dr George A. Mashour of University of Michigan Medical School and Dr Michael S. Avidan of Washington University, St Louis.

No Long-Term Cases of PTSD after Awareness during Anesthesia The long-term follow-up study included nine patients with a documented episode of intraoperative awareness during general anesthesia. All patients had "definite awareness with recall"—they accurately described events that occurred during their surgery. The patients were identified from previous Finnish studies of intraoperative awareness.

A median of 17.2 years after their episode of intraoperative awareness, the patients were evaluated on a battery of tests of psychosocial well-being. Assessment included formal diagnostic interviews for PTSD, along with anxiety, depression, and other psychiatric disorders. Nine patients with similar characteristics—who had undergone surgery without intraoperative awareness—were studied for comparison.

The results showed no significant difference in psychosocial outcomes for the patients with versus without intraoperative awareness. In particular, none of the patients with intraoperative awareness were diagnosed with PTSD.

In fact, in no patient did the episode of intraoperative awareness meet criteria for being a "potentially traumatic event" of the type leading to PTSD. Other measures of psychosocial well-being, including quality of life ratings, were also similar between groups. A few patients in each group had depression or other psychiatric disorders.

Ongoing Efforts Needed to Prevent Intraoperative Awareness Intraoperative awareness with recall is an uncommon but documented complication in patients undergoing general anesthesia. Previous studies have suggested that intraoperative awareness may place patients at risk for PTSD and other mental health conditions, such as depression or alcohol abuse. Because intraoperative awareness is rare, it is difficult to study the possible psychological after-effects.

Previous studies have reported high rates of PTSD after intraoperative awareness, but have had important limitations. For example, some studies have recruited patients through advertising, introducing a potential source of bias.

The new report is the longest follow-up study of patients with documented episodes of intraoperative awareness with recall. Dr Laukkala and coauthors note that the patients in their study received "appropriate psychosocial support and services" and explanations of their memories and symptoms—which may have lessened the long-term impact of the event.

The results suggest that intraoperative awareness doesn't necessarily increase the risk of PTSD and other mental health problems. The researchers write, "We emphasize that it is of utmost importance to try to prevent intraoperative awareness, and when recognized, potentially traumatized individuals should be offered support according to evidence-based guidelines."

While the findings are reassuring, they do not mean there's no risk of PTSD after an episode of intraoperative awareness, according to Drs Mashour and Avidan. In their editorial, they call for further studies to understand which procedures or patients are associated with a higher risk of intraoperative awareness and PTSD, to facilitate early recognition and prompt treatment.

Read the article in Anesthesia & Analgesia.

About Anesthesia & Analgesia Anesthesia & Analgesia was founded in 1922 and was issued bi-monthly until 1980, when it became a monthly publication. A&A is the leading journal for anesthesia clinicians and researchers and includes more than 500 articles annually in all areas related to anesthesia and analgesia, such as cardiovascular anesthesiology, patient safety, anesthetic pharmacology, and pain management. The journal is published on behalf of the IARS by Lippincott Williams & Wilkins (LWW), a division of Wolters Kluwer Health .

About the IARS The International Anesthesia Research Society is a nonpolitical, not-for-profit medical society founded in 1922 to advance and support scientific research and education related to anesthesia, and to improve patient care through basic research. The IARS contributes nearly $1 million annually to fund anesthesia research; provides a forum for anesthesiology leaders to share information and ideas; maintains a worldwide membership of more than 15,000 physicians, physician residents, and others with doctoral degrees, as well as health professionals in anesthesia related practice; sponsors the SmartTots initiative in partnership with the FDA; and publishes the monthly journal Anesthesia & Analgesia in print and online.

About Wolters Kluwer Health Wolters Kluwer Health is a leading global provider of information, business intelligence and point-of-care solutions for the healthcare industry. Serving more than 150 countries worldwide, clinicians rely on Wolters Kluwer Health's market leading information-enabled tools and software solutions throughout their professional careers from training to research to practice. Major brands include Health Language®, Lexicomp®, Lippincott Williams & Wilkins, Medicom®, Medknow, Ovid®, Pharmacy OneSource®, ProVation® Medical and UpToDate®.

Wolters Kluwer Health is part of Wolters Kluwer, a market-leading global information services company. Wolters Kluwer had 2013 annual revenues of €3.6 billion ($4.7 billion), employs approximately 19,000 people worldwide, and maintains operations in over 40 countries across Europe, North America, Asia Pacific, and Latin America. Follow our official Twitter handle: @WKHealth.

INFORMATION: END

ELSE PRESS RELEASES FROM THIS DATE:

KIT researchers protect the princess from the pea

2014-06-20

This news release is available in German. In the past years, invisibility cloaks were developed for various senses. Objects can be hidden from light, heat or sound. However, hiding of an object from being touched still remained to be accomplished. KIT scientists have now succeeded in creating a volume in which an object can be hidden from touching similar to a pea under the mattress of a princess. The results are now presented in the renowned Nature Communications journal. Magicians and illusionists make things disappear by means of a skilled use of mental ...

Citing 'urgent, acute' mental health issues, especially in Africa, experts petition gov'ts to act

2014-06-20

Calling global mental health problems "acute and urgent," 37 leading medical authorities from 11 countries have published a joint declaration calling for basic mental health care in Africa. The experts also call for global mental health objectives to be included among the United Nations' post-2015 Sustainable Development Goals, for a special UN General Assembly High Level Meeting on Mental Health by 2017, and for efforts to end the stigma and human rights violations inflicted on mental health patients. Published in the journal Global Health Action, the declaration was ...

Menthol cigarettes linked to increased smoking among teens

2014-06-20

Teens who use menthol cigarettes smoke more cigarettes per day than their peers who smoke non-menthols, says a new study. The findings from the Propel Centre for Population Health Impact at the University of Waterloo mark the first time that menthol cigarettes have been directly linked to elevated nicotine addiction among youth in Canada. "The appeal of menthol cigarettes among youth stems from the perception that they are less harmful than regular cigarettes. The minty taste helps mask the noxious properties, but the reality is that they are just as dangerous as any ...

UMN research: Nearly 4 percent of US babies born before full-term without medical reason

2014-06-20

New University of Minnesota research out this week is the first of its kind to show who is having early elective deliveries between 37 and 39 weeks gestation, and whether these deliveries happen following labor induction or cesarean. Labor induction or cesarean delivery without medical reason before a baby is considered full-term at 39 weeks, or an "early elective delivery," is associated with health problems for mothers and babies. The study, led by University of Minnesota School of Public Health Assistant Professor Katy Kozhimannil, Ph.D., M.P.A., in collaboration ...

Festschrift issue for Hilary Koprowski, MD

2014-06-20

New Rochelle, NY, June 20, 2014—The June issue of Monoclonal Antibodies in Immunodiagnosis and Immunotherapy is a special tribute issue for Hilary Koprowski, MD (1916-2013). The Festschrift papers are available online on the Monoclonal Antibodies in Immunodiagnosis and Immunotherapy website. An exclusive print copy of the Festschrift will be presented to all speakers at The Wistar Institute Symposium to honor Dr. Koprowski in Philadelphia on June 27, 2014, with support from CASIS™. "The contributors to this issue are internationally known scientists who were personally ...

Biology of infection: A bacterial ballistic system

2014-06-20

Many pathogenic bacteria use special secretion systems to deliver toxic proteins into host cells. Researchers of Ludwig-Maximilians-Universitaet (LMU) in Munich have determined the structure of a crucial part of one of these systems – which are possible targets for novel antibiotics. Bacteria secrete a broad range of specific proteins that can affect the behavior or survival of cells in their environment. Among the specialized transport systems responsible for the export of such factors are so-called Type VI secretion systems. In collaboration with Axel Mogk of the Center ...

Triggers and treatment of immediate-type allergic reactions

2014-06-20

Sudden allergic reactions can be fatal. The most common triggers of such reactions, also known as anaphylaxis, are wasp and bee venoms, legumes (pulses), animal proteins, and analgesics (painkillers). The incidence of anaphylaxis is age-dependent. In the current issue of Deutsches Ärzteblatt International, Margitta Worm (Berlin) and her co-authors describe the causes and treatment methods for anaphylaxis, based on data from the anaphylaxis registry of the German-speaking countries (Dtsch Arztebl Int 2014; 111: 367�). Worm and co-authors analyzed the data from the ...

The pig whipworm genome may aid to treat autoimmune diseases

2014-06-20

Shenzhen, June 15, 2014---An international team, composed of 11 institutions from six countries, including BGI, presented the whole-genome sequence of Trichuris suis, a parasitic worm in pig. Understanding the genetics mechanisms underlying the pig parasite may aid to modify the human immune response that could result in better treatments for autoimmune diseases, including inflammatory bowel disease (IBD) and multiple sclerosis. The latest research was published online in Nature Genetics. The human whipworm (Trichuris) infects around 1 billion people worldwide and causes ...

Cochrane review of RDTs for diagnosis of visceral leishmaniasis

2014-06-20

Researchers from the Cochrane Infectious Disease Group, co-ordinated through the editorial base in LSTM, conducted an independent review into the effectiveness of rapid diagnostic tests in diagnosing patients with visceral leishmaniasis (VL), published in The Cochrane Library today. VL (or kala-azar) is caused by a parasite and results in fever, a large spleen and other health problems. It occurs in India, Bangladesh and Nepal, east Africa, the Mediterranean region and Brazil. Without treatment it can be fatal, and proper treatment can result in cure, so diagnosis is ...

Creating friendships between African-American and Caucasian couples can reduce prejudice

2014-06-20

DETROIT — Recent research findings from Wayne State University show that the physical presence of romantic partners in intergroup friendships – friendships with different racial and ethnic groups, religious groups, or sexual orientations – positively influences interactions with people who are perceived to be different from themselves. The study, "Creating positive out-group attitudes through intergroup couple friendships and implications for compassionate love," currently available online in the Journal of Social and Personal Relationships, found that couples that interacted ...

Gelada monkeys understand complex "conversations" involving distress calls and prosocial comforting responses, exhibiting surprise when such vocal exchanges are manipulated to violate their expectatio

New poison dart frog discovered in the Amazon's Juruá River basin is blue with copper-colored legs, and represents one of just two novel Ranitomeya species in a decade

No evidence of long-term PTSD risk in patients with awareness during surgery

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: