The Effect of Suggestion on Unpleasant Dreams Induced by Ketamine Administration

Abstract

The use of ketamine may be associated with the recall of unpleasant dreams after sedation. We hypothesized that a positive suggestion before sedation could reduce the incidence of ketamine-induced unpleasant dreams. To test this hypothesis, we randomized 100 patients receiving sedation with ketamine for their procedure into 2 groups with 1 group having an anesthesiologist provide a mood-elevating suggestion to the patient before ketamine administration (suggestion group), whereas in the control group no suggestion was provided. Patients were provided with a pleasantness/unpleasantness scale to rate "the overall mood of the dream" as very unpleasant (grade 1), quite unpleasant (grade 2), neither or mixed (grade 3), quite pleasant (grade 4), and very pleasant (grade 5). In those patients who lost consciousness, the frequencies of grades 1, 2, 3, 4, and 5 were 0%, 0%, 46%, 24%, and 30% in the suggestion group and were 6%, 2%, 70%, 12%, and 10%, respectively, in the control group (P=0.01). In the intent-to-treat population the overall frequency between groups was very similar. This study implies that when administering ketamine as part of a sedation regimen, positive suggestion may help reduce the recall of unpleasant dreaming.

Case report of accidental poisoning with the tranquilizer xylazine and the anesthetic ketamine confirmed by qualitative and quantitative toxicological analysis using GC‐MS and LC‐MSn

“…In most cases, an initial, but mild hyperglycaemia could be observed. [11] In summary, the symptoms in the reported case could not definitively be assigned to ketamine or xylazine but were similar to the other reported xylazine poisonings. Twelve patients fully recovered and one patient died.…”

“…[10] Furthermore, nightmares were reported as adverse effects by ketamine in humans. [11] In summary, the symptoms in the reported case could not definitively be assigned to ketamine or xylazine but were similar to the other reported xylazine poisonings. [2,8] Only emesis and nightmares could additionally be observed.…”

Regarding the Transpersonal Nature of Ketamine Therapy: An Approach to the Work

“…Indeed, this issue is critical. In one anesthesia clinic the simple suggestion that a patient would find the emergence dreams after ketamine "pleasant" versus no suggestion increased the number of patients who rated emergence as "quite pleasant or very pleasant" from 22% to 54% (Cheong et al, 2011). The importance of this process-one that addresses the "set and setting" of the patient and treatment-has been established in the medical literature related to psychedelic therapy both past and present.…”

Non-opioid anesthetic drug abuse among anesthesia care providers: a narrative review

“…41 These neuropsychological and other effects, such as delusions, delirium, confusion, and depersonalization, [46][47][48][49] could be related to the inhibition of norepinephrine, dopamine, and serotonin uptake as well as the inhibition of cholinergic neuron activation of the prefrontal cortex. 46 Compared with other anesthetics, ketamine abuse is associated with less risk of immediate life-threatening effects due to its wide therapeutic range and the stability of cardiorespiratory function during ketamine anesthesia.…”