Abstract
BackgroundAnesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep.MethodsFifty-one patients, undergoing surgical excision of fibroadenomas under a Bispectral index-guided deep sedation anesthesia with propofol target controlled infusion, were enrolled into this prospective study. Psychological assessment was performed through the State Trait Anxiety Inventory. A questionnaire was adopted to register dreaming and anesthesia awareness. Data were collected after emergence (t0), 24 hours (t1), 1 month (t2), 6 months (t3).ResultsSix patients (12%) reported anesthetic dreaming at t0 confirming the response at each subsequent evaluation. One patient (2%) confirmed dreaming during anesthesia in all, but denied it at t0. There was a high correlation between the intraoperative dream contents and the features of dreams in natural sleep. No cases of anesthesia awareness were detected. A similar level of satisfaction was observed in dreaming and no-dreaming patients.ConclusionsAnesthetic dreaming does not seem to influence satisfaction of patients undergoing deep sedation with propofol target controlled infusion. A psychological assessment would seem to improve the evaluation of possible psychological consequences in dreamer patient.
Highlights
Dreaming during sedation or anesthesia is a fascinating phenomenon and very difficult to study
The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation
There was a high correlation between the intraoperative dream contents and the features of dreams in natural sleep
Summary
Dreaming during sedation or anesthesia is a fascinating phenomenon and very difficult to study. To what happens during natural sleep, probably only a limited number of dreams are recalled among all intraoperative experiences [1, 2]. After sedation the patient could better recall her/his dream. Sedation performed with a general anesthetic alone, and administered with a target controlled infusion (TCI) modality (which enables the drug concentration in the blood or plasma, or at the effect site to be controlled continuously) under a depth of anesthesia (DOA) monitoring guide, could represent an interesting model for research on the relationship between anesthesia and dreams. Anesthetic dreaming and anesthesia awareness are well distinct phenomena. The incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep
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