Dreams and ability to recall: Comparison between propofol and ketamine in patients undergoing surgery under IVA

Abstract

Background: Dreaming during anaesthesia is a common phenomenon. Dreams can occur with both inhalational agents as well as intravenous agents (IVA) like propofol and ketamine. But there are concerns like patient awareness, dreams and other untoward effects that may be associated with IVA. We have conducted this study to quantify the incidence of dreaming during IVA with propofol or ketamine.
 Methods: Sixty-nine patients aged 18 to 60 years scheduled for short procedures lasting from 5 to 25 minutes under IVA were randomized into two groups – group propofol or group ketamine. All the patients received midazolam and fentanyl intravenously. Then, patients in group propofol received propofol and those in ketamine group received ketamine for induction and maintenance of anaesthesia. After the end of surgery, when the patient were fully recovered from anaesthesia, patients were interviewed about occurrence of dreams and their ability to recall the dreams.
 Results: There were 35 patients in group propofol and 34 patients in group ketamine. The incidence of dreaming during anaesthesia was greater in patients of ketamine group, 23 (67.65%), when compared to propofol group, 7 (20%) (p < 0.001). Among the dreamers, 6 patients in the ketamine group and only 1 patient in the propofol group were able to recall their dream.
 Conclusion: Dreaming is quite common during IVA for short surgical procedure, more so following ketamine than propofol anaesthesia.

Ketamine-Induced Unresponsiveness Shows a Harmonic Shift from Global to Localised Functional Organisation

“…So, although volunteers are usually completely unresponsive when given high doses of ketamine, some sort of conscious experience seems to be preserved, as they are able to report afterwards. This is in line with previous studies investigating the occurrence of dreams and sensations in ketamine deep sedation (Hejja & Galloon, 1975; Jansen, 2001; Maya et al, 2018; Sarasso et al, 2015).…”

“…Another unique characteristic of ketamine-induced unresponsiveness is its ability to preserve some conscious experiences, most often seen in the form of vivid dreams and sensations (Collier, 1972; Bonhomme et al, 2016; Garfield et al, 1972; Hejja & Galloon, 1975; Krestow, 1974; Maya et al, 2018; Noreika et al, 2011; Sarasso et al, 2015). This is a useful property of the compound, as it allows researchers to disentangle the concepts of behavioural responsiveness and conscious awareness (Boly et al, 2013).…”