Anaesthesia: accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent and medicolegal issues

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The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: patient experiences, human factors, sedation, consent and medicolegal issues

Table 1. NAP5 suggestion for describing sedation definitions from a patient's perspective, as part of a process of consent.

	What will this feel like?	What will I remember?	What's the risk related to the sedation drugs?
Not sedated; awake	I am awake, possibly anxious. There may be some mild discomfort (depending on the what I am having done)	Everything	Zero: not applicable
Minimal sedation	I am awake and calm. There may be some mild or brief discomfort	Probably everything	Very low risk
Moderate sedation	I am sleepy and calm but remain in control. I may feel some mild discomfort	I might remember some things	Low risk
Deep sedation	I am asleep. I will not be in control	Probably very little	Higher risk. My breathing may stop when I am asleep –and I may need help to breathe – a tube might be inserted into my nose, mouth or windpipe. I will need oxygen and special monitoring
Anaesthesia	I am deeply ‘asleep’ and unable to respond	Very unlikely to remember anything	High risk (but the presence of an anaesthetist is designed to increase safety). My breathing may stop and my blood pressure and heart rate may fall. I will need a specialist doctor to look after my breathing and support my blood pressure and heart rate. I will need oxygen and special monitoring and equipment