- La mémorisation est un évènement indésirable rare (autour de 1 cas/1000 AG) mais toujours possible au cours d’une anesthésie générale, malgréles mesures de prévention qui doivent néanmoins être appliquées.
- Elle représente un traumatisme psychologique qui peut se chroniciser en syndromede stress post-traumatique, ou donner lieu à une plainte médicolégale.
- Elle est le plus souvent associée à un réveil peropératoire.
- Ce réveil est favorisé par la diminution des doses d’agent hypnotique, soit paraccident, soit en raison d’une mauvaise tolérance ce qui définit des populationsà risque.
- La curarisation ne favorise pas le réveil, mais empêche son diagnostic.
- La prévention repose sur la connaissance des concentrations de perte de conscienceet la gestion équilibrée de l’association hypnotique-morphinique, ajustéeà chaque individu par le monitoring de l’EEG.
CASE A 22-year-old man was brought to the ED complaining of abdominal pain after a rollover motor vehicle accident. He was the front seat passenger and was wearing a seat belt. Although he was trapped in the vehicle and it caught on fire, he did not suffer any cutaneous burns. History The patient's past medical history was significant for attention-deficit hyperactivity disorder. He admitted to using tobacco and alcohol socially, but denied illicit drug use. He denied any medication use or drug allergies. A review of systems was positive for complaints of abdominal pain and anxiety. Physical examination The patient's vital signs were: BP, 112/51 mm Hg; heart rate, 110 beats/minute; respirations, 23; SpO 2 , 95% on room air; and temperature, 37.4° C (99.3° F). On ED arrival, he was awake, alert, and oriented but appeared anxious and agitated. His pupils were equal, round, and reactive to light. His head was normocephalic with a 2-cm laceration on the left ear. The pati...
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