Intraoperative dreams reported after general anaesthesia are not early interpretations of delayed awareness

Samuelsson, Peter; Brudin, Lars; Sandin, R.

doi:10.1111/j.1399-6576.2008.01634.x

Cited by 25 publications

(21 citation statements)

References 21 publications

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“…Some researchers believed that intra-operative awareness is more likely to occur with intravenous agents, [23][24][25] but there were also contrasting opinions. 26 The statistical results of this investigation showed that the method of anesthesia (TIVA, inhalation anesthesia, balanced anesthesia, general anesthesia combined with nerve blockage) was definitely a relevant factor (OR 5 0.525, 95% CI: 0.392-0.703, for TIVA compared with inhalation anesthesia and balanced anesthesia; P 5 0.001) of intra-operative awareness. This suggested that intravenous or inhaled anesthetics indeed affected the presence of intra-operative awareness.…”

Section: Discussionmentioning

confidence: 70%

The incidence of intra‐operative awareness during general anesthesia in China: a multi‐center observational study

Yue

2009

Acta Anaesthesiol Scand

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Section: Discussionmentioning

confidence: 70%

The incidence of intra‐operative awareness during general anesthesia in China: a multi‐center observational study

Yue

2009

Acta Anaesthesiol Scand

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“…The described patient who had an episode of intraoperative awareness reported no dreams under general anesthesia. In our study, intraoperative dreaming was included in a separate category, not related to intraoperative awareness 7,60,61 ; however, some authors believe that their occurrence may result from inadequate level of anesthesia 59 . Our results are both interesting and clinically useful.…”

Section: Discussionmentioning

confidence: 99%

“…This corresponds with the literature, where the incidence of dreaming during general anesthesia varies between 1% and 22% (ref. 7,59,60 ). The described patient who had an episode of intraoperative awareness reported no dreams under general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Non-instrumental clinical monitoring does not guarantee an adequate course of general anesthesia. A prospective clinical study

Szostakiewicz¹,

Rybicki²,

Tomaszewski³

2018

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Background. Clinical monitoring is the most common method of adjusting the appropriate level of general anesthesia. However, episodes of intraoperative awareness (AWR) are still reported, suggesting that clinical observations may not be sufficient in some cases. The objective of this study was to compare the efficacy of clinical and instrumental neuromonitoring with auditory evoked potentials (AEP) in an intraoperative analysis of the proper level of general anesthesia. Methods. Patients scheduled for elective surgery were randomly divided into two groups. Subjects in the first group underwent intravenous, in the second group volatile anesthesia. The adequacy of anesthesia was analyzed using clinical parameters. All the participants were instrumentally monitored with the autoregressive AEP index (AAI). After the anesthesia, patients filled out a questionnaire on possible AWR. Results. Data of 208 patients (87 in the first, and 121 in the second group) were analyzed. Before surgery there were no changes in AAI values between groups (80 vs. 78, P=0.5192). The mean values of clinical parameters changed, but five minutes after the nociceptive stimuli. The mean values of AAI at analyzed time points were specific for general anesthesia. In patients under intravenous anesthesia, we found more episodes of too low (46/608 vs.15/847, P<0.000) anesthesia. One case of AWR was found in the TIVA group. Conclusions. AAI index is good indicator of patients' level of consciousness during general anesthesia. Standard clinical monitoring provides appropriate level of the procedure. However, it is insufficient during TIVA and does not prevent episodes of AWR.

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“…A level of general anesthesia appropriate for surgery is not sleep but rather a coma (Brown et al 2010). However, like sleep, general anesthesia is reversible and can allow dreaming (Leslie & Skrzypek 2007, Errando et al 2008, Samuelsson et al 2008). The concept of coma is less comforting and harder for patients to understand than the notion of sleep.…”

Section: Implications and Future Directionsmentioning

confidence: 99%

General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis

Brown

Purdon

Dort

2011

Annu. Rev. Neurosci.

452

403

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Placing a patient in a state of general anesthesia is crucial for safely and humanely performing most surgical and many nonsurgical procedures. How anesthetic drugs create the state of general anesthesia is considered a major mystery of modern medicine. Unconsciousness, induced by altered arousal and/or cognition, is perhaps the most fascinating behavioral state of general anesthesia. We perform a systems neuroscience analysis of the altered arousal states induced by five classes of intravenous anesthetics by relating their behavioral and physiological features to the molecular targets and neural circuits at which these drugs are purported to act. The altered states of arousal are sedation-unconsciousness, sedation-analgesia, dissociative anesthesia, pharmaco-logic non-REM sleep, and neuroleptic anesthesia. Each altered arousal state results from the anesthetic drugs acting at multiple targets in the central nervous system. Our analysis shows that general anesthesia is less mysterious than currently believed.

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Intraoperative dreams reported after general anaesthesia are not early interpretations of delayed awareness

Abstract: We found a statistically significant association between dreams reported after general anaesthesia and awareness, although intraoperative dreams were not an early interpretation of delayed awareness in any case. A typical dreamer in this study is a lean female having a short procedure.

Cited by 25 publications

References 21 publications

The incidence of intra‐operative awareness during general anesthesia in China: a multi‐center observational study

The incidence of intra‐operative awareness during general anesthesia in China: a multi‐center observational study

Non-instrumental clinical monitoring does not guarantee an adequate course of general anesthesia. A prospective clinical study

General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis

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