Background
A Caesarean section (CS) if performed under general anesthesia (GA) is a procedure with an increased risk of
accidental awareness. This study aimed to examine the incidence of accidental awareness under GA in
hospitals in the Republic of Srpska (Bosnia and Herzegovina) where GA for CS is performed in a significantly
higher percentage compared to spinal anesthesia.
Methodology
In the period from 2016 to 2018, a multicenter, prospective, observational study was conducted in five
medical centers in the Republic of Srpska (Bosnia and Herzegovina). The study included 1,161 patients who
underwent CS. A total of 427 (36.7%) patients had elective and 734 (63.3%) had emergency CSs. The patients
were surveyed postoperatively using the modified Brice questionnaire.
Results
Of the 1,161 patients included in the study, 12 (1.03%) reported memory in the period between induction
and emergence of anesthesia. Five (0.43%) of them reported definite and seven (0.6%) possible and unlikely
awareness. Significant psychological trauma due to pain was reported by two patients. Dreams during
anesthesia were reported by 42 patients (3.61%) and five of them stated that the dreams were unpleasant.
Conclusions
Accidental awareness under GA during CS has a significant incidence in medical centers in the Republic of
Srpska (Bosnia and Herzegovina). According to our findings, creating new protocols for GA when performing
CS is necessary.
