title: Flashback and nightmares after surgery under neuraxial anesthesia: a report of two cases.
abstract: Recall, awareness, flashback, and nightmares are reported complications of general anesthesia, but flashback and nightmares after regional anesthesia have not been described. Two patients underwent vascular and orthopedic surgery under spinal and epidural anesthesia, respectively. Local anesthetic consisted of bupivacaine, and sedation was achieved with the combination of fentanyl, midazolam, and diphenhydramine. In both patients the anesthetic course was uneventful, but the recovery process was complicated by flashbacks and nightmares leading to depression, physical complaints, and lengthy convalescence. Flashback and nightmares after neuraxial anesthesia are unreported and, therefore, their incidence is unknown.
authors.affiliation: Department of Psychiatry and Psychology, The Cleveland Clinic Foundation, OH 44195, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Scheman
authors.forename: A
authors.initials: A
authors.lastname: Gottlieb
authors.forename: J
authors.initials: J
authors.lastname: Sprung
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects; D019644:Arthroplasty, Replacement, Hip; D002045:Bupivacaine / Q000009:adverse effects; D004155:Diphenhydramine / Q000009:adverse effects; D004325:Dreams; D004837:Epinephrine; D005260:Female; D005283:Fentanyl / Q000009:adverse effects; D006801:Humans; D008874:Midazolam / Q000009:adverse effects; D008875:Middle Aged
chemical_list: D000759:Adjuvants, Anesthesia; D000779:Anesthetics, Local; D004155:Diphenhydramine; D008874:Midazolam; D005283:Fentanyl; D002045:Bupivacaine; D004837:Epinephrine