Dreaming and recall during sedation for colonoscopy.
Dreaming is reported by one in five patients who are interviewed on emergence from general anaesthesia, but the incidence, predictors and consequences of dreaming during procedural sedation are not known. In this prospective observational study, 200 patients presenting for elective colonoscopy under intravenous sedation were interviewed on emergence to determine the incidences of dreaming and recall. Sedation technique was left to the discretion of the anaesthetist. The incidence of dreaming was 25.5%. Patients reporting dreaming were younger than those who did not report dreaming. Doses of midazolam and fentanyl were similar between dreamers and non-dreamers, however propofol doses were higher in patients who reported dreams than those who did not. Patients reported short, simple dreams about everyday life--no dream suggested near-miss recall of the procedure. Frank recall of the procedure was reported by 4% of the patients, which was consistent with propofol doses commensurate with light general anaesthesia. The only significant predictor of recall was lower propofol dose. Satisfaction with care was generally high, however dreamers were more satisfied with their care than non-dreamers.
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria.
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Stait
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Leslie
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Bailey
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General / Q000379:methods / Q000523:psychology*; D018686:Anesthetics, Intravenous / Q000494:pharmacology*; D001315:Australia; D015331:Cohort Studies; D003113:Colonoscopy; D004305:Dose-Response Relationship, Drug; D004325:Dreams / Q000187:drug effects*; D017558:Elective Surgical Procedures; D005260:Female; D005283:Fentanyl / Q000494:pharmacology; D006801:Humans; D008297:Male; D011939:Mental Recall / Q000187:drug effects*; D008874:Midazolam / Q000494:pharmacology; D008875:Middle Aged; D017060:Patient Satisfaction; D015742:Propofol / Q000494:pharmacology; D011446:Prospective Studies; D055815:Young Adult
D018686:Anesthetics, Intravenous; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol