■麻醉做梦和麻醉意识是截然不同的现象。尽管术中知晓的发生率在手术后报告有梦的患者中更为常见,这两种现象之间的确切关联仍然是一个未解决的问题。这项研究的主要目的是调查麻醉梦,麻醉意识和心理后果最终发生在深度镇静下。术中做梦经历与自然睡眠中的梦特征相关。
■51名患者,在双频谱指数引导的丙泊酚靶控输注深度镇静麻醉下进行纤维腺瘤手术切除,被纳入这项前瞻性研究。通过状态特质焦虑量表进行心理评估。采用问卷记录做梦和麻醉意识。数据收集后出现(t0),24小时(t1),1个月(t2),6个月(t3)。
■6名患者(12%)在t0时报告了麻醉做梦,确认了每次后续评估的反应。一名患者(2%)在麻醉期间确认做梦,但在t0时否认。术中梦内容与自然睡眠中的梦特征之间存在高度相关性。没有发现麻醉意识的病例。在做梦和没有做梦的患者中观察到相似的满意度。
■麻醉做梦似乎并不影响丙泊酚靶控输注深度镇静患者的满意度。心理评估似乎可以改善对做梦患者可能的心理后果的评估。
UNASSIGNED: Anesthetic dreaming and anesthesia awareness are well distinct phenomena. Although the incidence of intraoperative awareness is more common among patients who reported a dream after surgery, the exact correlation between the two phenomena remains an unsolved rebus. The main purpose of this study was to investigate anesthetic dreaming, anesthesia awareness and psychological consequences eventually occurred under
deep sedation. Intraoperative dreaming experiences were correlated with dream features in natural sleep.
UNASSIGNED: Fifty-one patients, undergoing surgical excision of fibroadenomas under a Bispectral index-guided
deep sedation anesthesia with propofol target controlled infusion, were enrolled into this prospective study. Psychological assessment was performed through the State Trait Anxiety Inventory. A questionnaire was adopted to register dreaming and anesthesia awareness. Data were collected after emergence (t0), 24 hours (t1), 1 month (t2), 6 months (t3).
UNASSIGNED: Six patients (12%) reported anesthetic dreaming at t0 confirming the response at each subsequent evaluation. One patient (2%) confirmed dreaming during anesthesia in all, but denied it at t0. There was a high correlation between the intraoperative dream contents and the features of dreams in natural sleep. No cases of anesthesia awareness were detected. A similar level of satisfaction was observed in dreaming and no-dreaming patients.
UNASSIGNED: Anesthetic dreaming does not seem to influence satisfaction of patients undergoing
deep sedation with propofol target controlled infusion. A psychological assessment would seem to improve the evaluation of possible psychological consequences in dreamer patient.