Intraoperative awareness: controversies and non-controversies

Intraoperative awareness, with or without recall, continues to be a topic of clinical significance and neurobiological interest. In this article, we review evidence pertaining to the incidence, sequelae, and prevention of intraoperative awareness. We also assess which aspects of the complication are well understood (i.e. non-controversial) and which require further research for clarification (i.e. controversial). Key words: anaesthesia, awareness, consciousness, post-traumatic stress disorder Editor’s key points • Recent large prospective studies have addressed the incidence, detection, and prevention of awareness under general anaesthesia. • While important controversies remain, a number of con-cepts regarding intraoperative awareness can be consid-ered non-controversial. • Controversies remain in both the aetiological and the neurobiological bases of awareness