NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■ 
            A study of patient reports
    • Not all AAGA is remembered
    • Even light sedation prevents recall on recovery 
    • Patients can be responsive during GA but 
       remember nothing on recovery
           100
            80                  From Russell (1993): 72% IFT 
            60                  response, 0% postoperative 
          s 40                  recall
          t
          n 20
          e
          t
          a 0
          p
                                l
                e    ry   e    l
                s         c    a
          %    n    e    ri    c
               o    g    B    e
                    r         r
              p    u     l     
              s    s    al   d
              e         c    e                              NAP5
              r    g         t
             T    n    e    p
                  i    r
             F    r     
            I    u    us   om                   The 5th National Audit Project
                 d    o    r
                n    e     p
                ai   n                                              ■ ■ ■ 
                     a
               p    nt
                   po                      ■ ■ 
                   s
                                                             NAP5
                                                 The 5th National Audit Project
                                                                      ■ ■ ■ 
                                             ■ ■ 
                  Memory for AAGA
    Previous studies have          • 1-2 per 1000
    tried to elicit recall by      • 1 in 3 reported > 1 week
    repeatedly interviewing        • Wide variation in 
    patients using the               patients’ experiences of 
    modified Brice procedure         AAGA
                                   • Auditory perceptions are 
                                     common, as are feelings 
                                     of helplessness and fear 
                                                             NAP5
                                                 The 5th National Audit Project
                                                                      ■ ■ ■ 
                                             ■ ■ 
                                                           NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■ 
                 How memory works
                        • Why so few?
                      • Why the delay?
                    • Can we trust them?
                                                            NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■ 
                                                           NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■ 
              Why so few memories?
    • Memories are reconstructed not replayed
    • Need to understand the experience:
                                Bransford & Johnson (1972)
    • Need to know source of the memory 
       (otherwise imagination or dream)
    • Need to have unique retrieval cues
                                                            NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■ 
                                                           NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■ 
               Why is recall delayed?
    • Memories are over-written by more recent 
       memories
    • Shared retrieval cues
    • AAGA patent regains consciousness at least 
       twice
                                                            NAP5
                                                The 5th National Audit Project
                                                                    ■ ■ ■ 
                                           ■ ■