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Introduction. Awareness with recall of intraoperative events is an infrequent but potentially devastating complication of general anesthesia, with a reported incidence of 0.1-0.2% in low-risk patients. Higher incidence is expected in resource-limited operation room setups and in high-risk patients. Awareness can result in significant distress to patients and long-term psychological consequences, including symptoms associated with posttraumatic stress disorder, anxiety, night mares, night terror, dissatisfaction with surgical service, and sometimes even suicide. Objective. To assess the magnitude and associated factors of awareness with recall under general anesthesia in Amhara regional state referral hospitals. Method. An institution-based cross-sectional study was conducted on 1065 patients who underwent surgery under general anesthesia from January 1 to June 30, 2018. The study participants were selected by systematic random sampling from 4 referral hospitals. The modified Brice questionnaire was used to detect awareness under general anesthesia. Interviewer-administered structured questionnaire and chart review were employed. Data with complete information were entered in to SPSS version 20 computer software. Descriptive statics and bivariate and multivariable analysis were computed. A P-value less than 0.2 was used to select candidate variables for multivariable logistic regression. A P-value less than 0.05 was used to declare statistical significance. Result. 1065 patients were included in the study which makes the response rate of 90.7%. The magnitude of awareness with recall under general anesthesia was found to be 8.2% of which 4.9%, 2.6%, and 0.7% of patients reported hearing voice, pain, and sensation of breathing tube, respectively. Lack of premedication was the only significantly associated factor for awareness with recall under general anesthesia (AOR = 3.014, 95% CI (1.201 to 7.565)). Conclusion and Recommendation. Our study showed higher magnitude of awareness with recall under general anesthesia. Lack of premedication was the only associated factor with awareness with recall under general anesthesia. Anesthetists should give emphasis to prevent the possibility of awareness under general anesthesia by providing premedication. Cohort studies should be done including the consequences of awareness with recall under general anesthesia.

Introduction. The significance of difficult or failed tracheal intubation following induction is a well-recognized cause of morbidity and mortality in anesthetic practice. Nevertheless, the need to predict potentially difficult tracheal intubation has received a little attention. During routine anesthesia, the incidence of difficult tracheal intubation has been estimated at 1.5%–8% of general anesthetics. Difficulties in intubation have been associated with serious complications, such as brain damage or death, particularly when failed intubation has occurred. Occasionally, in a patient with a difficult airway, the anesthetist is faced with the situation where mask ventilation proves difficult or impossible. This is one of the most critical emergencies that may be faced in the practice of anesthesia. If the anesthetist can predict which patients are likely to prove difficult to intubate, he/she may reduce the risks of anesthesia considerably. In Ethiopia, there are no data on the magnitude of difficult laryngoscopic tracheal intubation and no standard guidelines for preoperative tests. The main concern of this study was to provide information on the magnitude of difficult laryngoscopic intubation and to determine valuable preoperative tests to predict difficult laryngoscopy and intubation in patients with apparently normal airways which can help anesthetists to improve preoperative airway assessment and contribute to decrease anesthesia-related morbidity and mortality. Objective. The main objective of this study was to assess the magnitude and predictive values of preoperative tests for difficult laryngoscopy and intubation, among surgical patients who underwent elective surgery under general anesthesia with endotracheal intubation in Tikur Anbessa Hospital from February 1 to March 30, 2016. Study Design. A facility-based cross-sectional study design was used. Result. In this study, we found the magnitude of difficult laryngoscopy and intubation as 13.6% and 5%, respectively. 33.3% of patients with difficult laryngoscopy were found to be difficult for intubation. Mallampati test, interincisor distance, and thyromental distance were identified to be good preoperative tests to predict difficult laryngoscopic intubation when used in combination. Recommendation. We recommend anesthesia professionals to use combination of MMC/TMD/IID for their routine preoperative airway assessment.