Awareness during anaesthesia for implantable cardioverter defibrillator implantation : recall of defibrillation shocks

Summary Implantable cardioverter defibrillator implantation is performed under general anaesthesia. This report describes awareness or recall in two of 33 patients scheduled for implantation. After induction, anaesthesia was maintained using continuous infusions of propofol and atracurium and intermittent boluses of alfentanil. Propofol was given in the same arm as the implantation side. In these two patients propofol flowed out of the bleeding central venous access. To minimise the possibility of awareness, we advise that continuous infusions should be administered intravenously on the contralateral side to the implantation and that neuromuscular blocking agent be given by intermittent bolus injections.