Abstract
Background and objectives: Dreaming is a commonly reported side effect of propofol anesthesia. Materials and Methods: We investigated the inci-dence and character of dreams in patients undergoing intravenous propofol anesthesia and cor-related it with an observer rating scale of facial expression on the seven-point scale from pain to smile. A total of 124 patients undergoing gastrointestinal endoscopy were recruited in the pro-spective observational study. Bispectral index (BIS), blood pressure (BP), and pulse were moni-tored. Upon emergence from anesthesia, the patient’s facial expression was rated numerically. Thereafter, patients were asked whether they had dreams and to rate their dreams as pleasant or unpleasant. The mean age of participants was 53; body mass index, 26.17; duration of procedure, 20 min; and average propofol dose, 265 mg. Results: Dreaming was reported by 43% of patients. Dreams were pleasant in all but one patient. There was a significant correlation of the observer’s rating of facial expression with dreaming (r = 0.260; p = 0.004). Dreamers had higher scores of observer rating of facial expression (1 (0–2) vs. 0.5 (0–1), p = 0.006). Conclusions: BIS values were lower in the dreamers vs. non-dreamers 2 min after the endoscopy started (48 (43–62) vs. 59 (45–71), p = 0.038). Both BIS and observer ratings correlate with dreaming in patients undergoing gastrointestinal endos-copy. Trial registration number: NCT04235894.
Highlights
Propofol is an intravenous agent widely used in clinical settings for induction of general anesthesia or sedation
We investigated whether observer rating score correlates with the presence of dreams under propofol anesthesia for gastrointestinal endoscopies
After the patient was admitted to the endoscopy unit, a peripheral venous cannula was inserted, and blood pressure (BP), pulse, and Bispectral index (BIS) were registered in all patients using Draeger Infinity Delta XL monitors
Summary
Propofol is an intravenous agent widely used in clinical settings for induction of general anesthesia or sedation. Its use is increasing in ambulatory diagnostic and therapeutic procedures being undertaken in gastrointestinal endoscopy, bronchoscopy, and radiology suites, as well as in ICUs [1]. A meta-analysis of the use of propofol in gastrointestinal endoscopy showed it is safe and effective either alone or in combination with traditional sedatives, including benzodiazepines and opioids [2]. Its use was associated with shorter recovery and discharge periods, higher post-anesthesia recovery scores, better sedation, and greater patient cooperation than traditional sedation, without an increase in cardiopulmonary complications [3]. Fast recovery, and few side effects are the advantages of propofol in clinical practice. It is generally recognized to be safe for anesthesia and sedation
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