9Dreaming during anaesthesia in adult patients
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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Cited by (22)
On no man's land: Subjective experiences during unresponsive and responsive sedative states induced by four different anesthetic agents
2021, Consciousness and CognitionCitation Excerpt :It has therefore been suspected that dreaming during surgical anesthesia does not occur during the actual administration phase, but during the recovery period when anesthesia transforms to natural sleep (Leslie et al., 2007). As dream reports most likely capture only those experiences which have been present just prior to the awakening (Leslie & Skrzypek, 2007; Windt, 2015), delayed interviews, especially in a surgical but also in an experimental setting, are susceptible to amnesia. However, in an experimental study where healthy participants were roused during constant infusion of dexmedetomidine or propofol, and also interviewed after recovery from deeper unresponsive sedation, participants reported dream-like experiences equally often during the constant infusion and after recovery period (Radek et al., 2018).
Intraoperative awareness and experience with a ketamine-based anaesthesia package to support emergency and essential surgery when no anaesthetist is available
2019, African Journal of Emergency MedicineCitation Excerpt :In the general population, 20 to 26% of patients who undergo procedural sedation and 22% who undergo general anaesthesia report intraoperative dreaming [21]. Controversies exist whether there is a correlation between dreaming and awareness [22,23]. Even though more than half of the participants in this study reported dreaming, only one fourth of those reported intraoperative awareness.
Dreaming and awareness during dexmedetomidine- and propofol-induced unresponsiveness
2018, British Journal of AnaesthesiaCitation Excerpt :However, all previous studies addressed the incidence of dreaming in surgical patients or experimental participants after a significant temporal delay, leaving the question open of whether dreaming occurs during drug administration or during emergence.4–9 It has been suggested that dreaming is limited to the short period before awakening, when patients are sedated or in a physiological sleep state.5,13,22 Given this, we expected that dreaming would be more frequently reported after the recovery period.
Introduction to cognitive activity during anaesthesia
2007, Best Practice and Research: Clinical AnaesthesiologyDreaming during anesthesia and sedation
2011, Anesthesia and AnalgesiaDreaming in sedation during spinal anesthesia: A comparison of propofol and midazolam infusion
2011, Anesthesia and AnalgesiaCitation Excerpt :However, contrary to our hypothesis, the majority of dreams in the current study (36 of 56 dreamers, 64.3%) were simple, pleasant ruminations about everyday life. They were similar in nature to the dreams after general anesthesia.5,13 Dreams that included imaginary experiences of the operation were reported in 5 cases.