BackgroundImages evoked immediately before the induction of anesthesia with the help of suggestions may influence dreaming during anesthesia.The aim of the study was to assess the incidence of evoked dreams and dream recalls by employing suggestions before induction of anesthesia while administering different general anesthetic combinations.MethodsThis is a single center, prospective randomized including 270 adult patients scheduled for maxillofacial surgical interventions. Patients were assigned to control, suggestion and dreamfilm groups according to the psychological method used. According to the anesthetic protocol there were also three subgroups: etomidate & sevoflurane, propofol & sevoflurane, propofol & propofol groups. Primary outcome measure was the incidence of postoperative dreams in the non-intervention group and in the three groups receiving different psychological interventions. Secondary endpoint was to test the effect of perioperative suggestions and dreamfilm-formation training on the occurrance of dreams and recallable dreams in different general anesthesiological techniques.ResultsDream incidence rates measured in the control group did not differ significantly (etomidate & sevoflurane: 40%, propofol & sevoflurane: 26%, propofol & propofol: 39%). A significant increase could be observed in the incidence rate of dreams between the control and suggestion groups in the propofol & sevoflurane (26%-52%) group (p = 0.023). There was a significant difference in the incidence of dreams between the control and dreamfilm subgroup in the propofol & sevoflurane (26% vs. 57%), and in the propofol & propofol group (39% vs.70%) (p = 0.010, and p = 0.009, respectively). Similar to this, there was a significant difference in dream incidence between the dreamfilm and the suggestion subgroups (44% vs. 70%) in the propofol & propofol group (p = 0.019). Propofol as an induction agent contributed most to dream formation and recalls (χ2-test p value: 0.005). The content of images and dreams evoked using suggestions showed great agreement using all three anesthetic protocols.ConclusionThe psychological method influenced dreaming during anesthesia. The increase of the incidence rate of dreams was dependent on the anesthetic agent used, especially the induction agent.The study was registered in ClinicalTrials.gov. Identifier: NCT01839201.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2253-15-11) contains supplementary material, which is available to authorized users.
BackgroundImages evoked immediately before the induction of anesthesia by means of suggestions may influence dreaming during anesthesia. This study is a retrospective re-evaluation of the original prospective randomized trial.MethodsDream reports were studied in two groups. In group 1. dreams of patients who received suggestions, and in group 2, those of the control group of patients who did not. The incidence of dream reports and the characteristics and the theme of the reported dreams were compared among the groups.ResultsIn general, the control and the psychological intervention groups were different in terms of dreaming frequency, and non-recall dreaming. The incidence of dream reports was significantly higher in the suggestion group (82/190 at 10 min and 71/190 at 60 min respectively) than in the control group (16/80 at 10 min and 13/80 at 60 min, respectively; p10 = 0.001 and p60 = 0.002). There were no differences in the nature (thought- like or cinematic), quality (color or B&W) and the mood (positive vs. negative) of the recalled dreams. In general, the contents of the imaginary favorite place and the reported dream were identical in 73.2 %. Among the topics most successfully applied in the operating theater were loved ones (83.8 %), holiday (77.8 %) and sport (63.6 %).ConclusionThe results of the present study suggest that dreams during anesthesia are influenced by suggestions administered immediately preceding anesthesia.Trial registrationThe study was registered in ClinicalTrials.gov. Identifier: Q1 NCT01839201, Date: 12 Apr. 2013.
Pain, as subjective content of consciousness, is an essential attention-calling sign that helps to survive. Pain relieve is obligatory for every physician, thus, its individual appearance can make the analgesia difficult to carry out. The improving neuroimaging techniques allow understanding the development of pain sensation. Through the 24 articles on the PubMed found with keywords 'pain' and 'neuroimaging', we review here the parts of the pain neuron matrix, their tasks and the assumed mechanism of the acute pain sensation. The mechanism of the individual pain sensation is illustrated by the view of the modular function of the medial part of the pain matrix. Experimental results of empathic pain suggest that pain sensation may occur without real damage of the tissues, as well. The pain network plays main role in chronic pain.
A hipnoterápiát régóta használják fájdalomcsillapító eljárásként, mégis meglehetősen ismeretlen a betegek és a gyógyítók előtt is. Hipnóziskutatók kitartó munkájának eredményeként jelentős ismereteket szerezhetünk a módszer neurofiziológiai hátteréről, hatásmechanizmusairól. Célunk az, hogy eredményeiket beillesztve napjaink fájdalomkutatásának perspektívájába a gyógyítók szélesebb rétege számára tegyük megismerhetővé. Az utolsó 15 évben az agyi képalkotó technikák ugrásszerű fejlődése lehetővé tette a kutatók számára, hogy tanulmányozzák a fájdalom élményének kialakulásában részt vevő agyterületeket, amelyeket közösen fájdalomhálózatnak vagy a fájdalom neuron-mátrixának nevezünk. Bemutatjuk a pszichoterápiák fájdalomcsillapító hatásának alapmechanizmusaiként értelmezhető kognitív szabályozási folyamatokat, a figyelem, az előzetes elvárások és az újraértékelés, valamint a hangulat moduláló szerepét. A fájdalom neuron-mátrixa aktiválódhat a testet ért fizikai inger hatására, de e nélkül is, a mediális rész elsődleges aktiválódása útján. Mindez hozzásegíthet a krónikus fájdalomállapotok keletkezési mechanizmusának a jobb megértéséhez. A hipnózisban végzett fájdalomcsillapítási vizsgálatok eredményei részben a módosult tudatállapot, részben a fájdalomcsillapítás idegrendszeri hátteréről is tájékoztatnak.
According to the basic assumption of pain research, the activity of pain matrix shows an increase in functional neuroimaging studies during nociceptive stimulation whose extent is correlated with the intensity of the stimulus and that of the emerged experience of pain. Research conducted over the past decade has questioned this assumption. In order to understand the controversial findings I have reviewed new results of pain research. In order to get to know more about “hardware”, I reviewed the direct relationships between members of the pain network. With a view to understand the mechanism of the development of pain perception, the “software”, I give a brief description of the functioning of the salient as well as attention and executive control network. To have a better understanding of “hardware”, I examined the behavior of the pain network of patients incapable of feeling pain in aversive situations. In the review I introduced the thought-provoking knowledge of the pain for all experts, regardless of this specialty by presenting the results of pain research.
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