Factores asociados al despertar intraoperatorio. Revisión sistemática

Abstract

Introduction: intraoperative awareness during surgery is a rare adverse effect, however, its appearance can cause serious and long-term disabling psychological disorders. Objective: to determine the factors associated with intraoperative awakening in patients undergoing surgical interventions, through a systematic review. Methods: observational study of literature review. Original scientific articles with quality of evidence in category Q1 to Q4 of Scimago Journal and Country Rank during the last 10 years were included. The information was obtained through the search engines: Hinari, Scopus, Redalyc, Scielo, Pubmed, Springer, NJM, BMJ, Cochrane, Latindex and Google Scholar. It consisted of placing keywords with the combination of these through Boolean operators. For data collection, the PICOs strategy was used. The information was consolidated in personalized tables for this purpose. Results: the prevalence of intraoperative awakening ranged from 0.0095% to 8.2%. The risk factors identified with statistical significance were age <60 years, women, obesity, low weight, ASA III-IV, history of prior intraoperative awareness, prolonged interventions, high-risk and emergency surgeries, general anesthesia, and lack of pre medication. Sedation and the application of perioperative analgesia are protective factors. Conclusions: intraoperative awareness is a rare complication during the surgical act, the risk factors were due to determinants related to the patient, the type of surgical intervention and the anesthetic technique.