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How to improve awareness and awakeness?

Randomized controlled trial

General anaesthesia

Akinetic mutism

Bispectral index

Brain stimulation

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To enhance awareness and awakeness in patients with disorders of consciousness (DOC), various interventions can be considered. Frontal near infrared laser stimulation (N-LT) and transcranial focused shock wave therapy (F-SWT) have shown promise in promoting alertness in chronic DOC patients . Additionally, anaesthetic depth monitors like the Bispectral Index monitor can help maintain unconsciousness during surgery, reducing the risk of awareness . Specific drugs such as ketamine, etomidate, and benzodiazepines have been found to lower the risk of wakefulness and awareness compared to other anaesthetics, highlighting their potential in managing consciousness levels . These interventions and monitoring techniques play crucial roles in improving awareness and awakeness in patients with DOC or in preventing unwanted intraoperative consciousness during surgery.

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Open access•Journal Article•DOI Anaesthetic interventions for prevention of awareness during surgery. Anthony G Messina, Michael Wang, Marshall J Ward, Chase C Wilker, Brett B Smith, Daniel P. Vezina, Nathan L. Pace - Show less +6 more 18 Oct 2016-Cochrane Database of Systematic Reviews 52 Citations	To reduce awareness, consider anaesthetic depth monitors like Bispectral Index. For minimizing awakeness, use drugs like ketamine, etomidate, benzodiazepines, or adjust inhaled anaesthetic doses.
Journal Article•DOI [Awareness - clinical relevance]. Stefanie Pilge, Gerhard Schneider - Show less +1 more 30 Jan 2013-Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie 4 Citations	To improve awareness and awakeness, follow recommendations for detecting intraoperative awareness, managing postoperative memory, and preventing awareness during general anesthesia based on clinical guidelines and risk factors.
Journal Article•DOI Detection of awareness with the bispectral index: two case reports. Martin Luginbühl, Thomas W. Schnider - Show less +1 more 01 Jan 2002-Anesthesiology 41 Citations	To improve awareness and awakeness during anesthesia, utilize the Bispectral Index (BIS) monitor to maintain a BIS value between 40-60 for adequate depth, preventing explicit awareness incidents.
Journal Article•DOI Non-invasive brain stimulation to promote alertness and awareness in chronic patients with disorders of consciousness: Low-level, near-infrared laser stimulation vs. focused shock wave therapy. Cordula Werner, Manuela Byhahn, Stefan Hesse - Show less +2 more 11 Apr 2016-Restorative Neurology and Neuroscience 8 Citations	Non-invasive methods like near-infrared laser stimulation and shock wave therapy can potentially enhance alertness and awareness in chronic patients with disorders of consciousness, as indicated in the study.

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