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Dreaming during anaesthesia in adult patients

https://doi.org/10.1016/j.bpa.2007.05.003Get rights and content

Dreaming during anaesthesia is defined as any recalled experience (excluding awareness) that occurred between induction of anaesthesia and the first moment of consciousness upon emergence. Dreaming is a commonly-reported side-effect of anaesthesia. The incidence is higher in patients who are interviewed immediately after anaesthesia (≈22%) than in those who are interviewed later (≈6%). A minority of dreams, which include sensory perceptions obtained during anaesthesia, provide evidence of near-miss awareness. These patients may have risk factors for awareness and this type of dreaming may be prevented by depth of anaesthesia monitoring. Most dreaming however, occurs in younger, fitter patients, who have high home dream recall, who receive propofol-based anaesthesia and who emerge rapidly from anaesthesia. Their dreams are usually short and pleasant, are related to work, family and recreation, are not related to inadequate anaesthesia and probably occur during recovery. Dreaming is a common, fascinating, usually pleasant and harmless phenomenon.

Section snippets

Dreaming during sleep

Dreaming during sleep is defined as “any type of cognitive activity occurring during sleep”1 and is “a subjective experience that is solely accessible by recollection of the dreamer after awakening”.2 Despite more than a century of scientific enquiry, dreams continue to intrigue sleep scientists and are still not fully understood.

During sleep, the electroencephalogram (EEG) undergoes significant changes corresponding to different stages of the sleep cycle. When combined with information from

Dreaming during anaesthesia

Dreaming during anaesthesia can be defined as “any experience (excluding awareness) that a patient is able to recall and which he or she thinks occurred between induction of anaesthesia and the first moment of consciousness after anaesthesia”.8 As opposed to post-anaesthetic hallucinations, which occur when the patient appears to be awake and believes he or she was awake, dreaming occurs when the patient appears and believes he or she is unconscious or “asleep”.

Summary

Dreaming is commonly reported after anaesthesia but remains poorly understood. Occasional patients may formulate sensory perceptions obtained during inadequate anaesthesia into dreams. These patients may have risk factors for awareness and may show evidence of inadequate anaesthesia during surgery. It is likely that near-miss awareness dreams may be prevented by depth of anaesthesia monitoring. However, most dreaming is not related to light or inadequate anaesthesia. The characteristics and

Acknowledgement

This work was supported by the Douglas Joseph Professorship – a grant from the Australian and New Zealand College of Anaesthetists. Some material in this chapter formed part of a Bachelor of Medical Science thesis for the University of Melbourne.

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