The effect of preoperative suggestions on perioperative dreams and dream recalls after administration of different general anesthetic combinations: a randomized trial in maxillofacial surgery

Abstract

BackgroundImages evoked immediately before the induction of anesthesia with the help of suggestions may influence dreaming during anesthesia.The aim of the study was to assess the incidence of evoked dreams and dream recalls by employing suggestions before induction of anesthesia while administering different general anesthetic combinations.MethodsThis is a single center, prospective randomized including 270 adult patients scheduled for maxillofacial surgical interventions. Patients were assigned to control, suggestion and dreamfilm groups according to the psychological method used. According to the anesthetic protocol there were also three subgroups: etomidate & sevoflurane, propofol & sevoflurane, propofol & propofol groups. Primary outcome measure was the incidence of postoperative dreams in the non-intervention group and in the three groups receiving different psychological interventions. Secondary endpoint was to test the effect of perioperative suggestions and dreamfilm-formation training on the occurrance of dreams and recallable dreams in different general anesthesiological techniques.ResultsDream incidence rates measured in the control group did not differ significantly (etomidate & sevoflurane: 40%, propofol & sevoflurane: 26%, propofol & propofol: 39%). A significant increase could be observed in the incidence rate of dreams between the control and suggestion groups in the propofol & sevoflurane (26%-52%) group (p = 0.023). There was a significant difference in the incidence of dreams between the control and dreamfilm subgroup in the propofol & sevoflurane (26% vs. 57%), and in the propofol & propofol group (39% vs.70%) (p = 0.010, and p = 0.009, respectively). Similar to this, there was a significant difference in dream incidence between the dreamfilm and the suggestion subgroups (44% vs. 70%) in the propofol & propofol group (p = 0.019). Propofol as an induction agent contributed most to dream formation and recalls (χ2-test p value: 0.005). The content of images and dreams evoked using suggestions showed great agreement using all three anesthetic protocols.ConclusionThe psychological method influenced dreaming during anesthesia. The increase of the incidence rate of dreams was dependent on the anesthetic agent used, especially the induction agent.The study was registered in ClinicalTrials.gov. Identifier: NCT01839201.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2253-15-11) contains supplementary material, which is available to authorized users.

Anesthetic dreaming, anesthesia awareness and patient satisfaction after deep sedation with propofol target controlled infusion: A prospective cohort study of patients undergoing day case breast surgery

“…However, compared with the previous Leslie’s investigation, our study presented a different anesthesia setting and it was drawn with a different methodology. Because Gyulahazi et al [ 41 ] demonstrated that dream recalls are more frequent in patients with preoperative suggestions applied before and during induction, in our study patients do not received suggestions. The correlation between dreaming and BIS has been previously investigated.…”

“…This phenomenon was more evident with ketamine (‘ketamine dreams’) rather than other agents (e.g., propofol) [ 7 ]. When ketamine is not used, recent reports showed that intraoperative dreams seems to have similar incidence independent of the anesthetic technique [ 8 ]. Previous studies, however, have reported that patients receiving propofol anesthesia had a higher incidence of dreaming than those receiving volatile anesthesia [ 9 , 10 ].…”

Dreaming under anesthesia: is it a real possiblity? Investigation of the effect of preoperative imagination on the quality of postoperative dream recalls

“…A total of 270 patients were included in the study. Table 1 summarizes data on their confounding factors and preoperative history (data taken from [ 8 ]).…”

“…It has been demonstrated that dream recalls are more frequent in patients with preoperative suggestions applied before and during induction. Furthermore, formation of dreams and dream recalls were dependent on the anesthetic technique, especially propofol as an induction agent [ 8 ].…”

The role of hypnotherapy in evidence‐based clinical practice

“… General patient relaxation , improving the treatment experience for patient, operator and assistants Specific dental phobias such as needles, sound of drill, surgery environment Complementing the use of nitrous oxide (Whalley and Brooks, ) Encouraging compliance with oral hygiene regimes Improving tolerance for orthodontic appliances Modification of unwanted oral habits, for example bruxism (poor evidence – Lobbezoo et al , ) Modification of the use of anaesthetics, analgesics and sedation (Gyulaházi et al , ; Wolf et al , ) Replacing or supplementing pre‐medication (Calipel et al , ) Controlling salivary flow and bleeding (Abdeshahi et al , ; Satzl et al , ) Treating chronic facial pain/temporomandibular disorders (Abrahamsen et al , , ) …”