5th National Audit Project (NAP5)


NAP5 was a collaborative project run by the AAGBI and the Royal College of Anaesthetists. The NAP5 Report focuses on failure of general anaesthesia - that is when general anaesthesia is intended yet the patient remains conscious.  Accidental awareness during general anaesthesia (AAGA) ranks high among concerns of both patients and anaesthetists.  It is one of the most common concerns for patients to discuss before surgery, and both patients and anaesthetists rank it high in outcomes to avoid during anaesthesia, to the point that, after death, 'awareness with pain' is the outcome anaesthetists most wish to avoid.

The NAP5 study is by a considerable margin, the largest ever study of the topic in the world.  We believe its findings are robust as a result of its size (capturing data from every public hospital in the UK and Ireland) and depth (involving detailed prospectively acquired reports and multidisciplinary structured analysis of their content and themes).  First and foremost, NAP5 is a report for patients as it is based entirely on patients' reports of their experiences.  Yet our aim is also that it will have an impact on national, institutional and individual practice of anaesthesia, so that the incidence of AAGA can be significantly reduced, and where it occurs it can be recognised and managed in such a way as to mitigate any longer term effects on patients.

NAP5 full report

NAP5 logoFurther details of the project and the full report are available by visiting the NAP5 website >

NAP5 press release - 10 Sept 2014

Largest ever study of awareness during general anaesthesia identifies risk factors and consequences for patients, including long-term psychological harm. Read the full press release >