Dreaming in sedation during spinal anesthesia: a comparison of propofol and midazolam infusion.
BACKGROUND
Although sedation is often performed during spinal anesthesia, the details of intraoperative dreaming have not been reported. We designed this prospective study to compare 2 different IV sedation protocols (propofol and midazolam infusion) with respect to dreaming during sedation.


METHODS
Two hundred twenty adult patients were randomly assigned to 2 groups and received IV infusion of propofol or midazolam for deep sedation during spinal anesthesia. Patients were interviewed on emergence and 30 minutes later to determine the incidence, content, and nature of their dreams. Postoperatively, patient satisfaction with the sedation was also evaluated.


RESULTS
Two hundred fifteen patients (108 and 107 in the propofol and midazolam groups, respectively) were included in the final analysis. The proportion of dreamers was 39.8% (43/108) in the propofol group and 12.1% (13/107) in the midazolam group (odds ratio=4.78; 95% confidence interval: 2.38 to 9.60). Dreams of the patients receiving propofol were more memorable and visually vivid than were those of the patients receiving midazolam infusion. The majority of dreams (36 of 56 dreamers, 64.3%) were simple, pleasant ruminations about everyday life. A similarly high level of satisfaction with the sedation was observed in both groups.


CONCLUSIONS
In cases of spinal anesthesia with deep sedation, dreaming was almost 5 times more common in patients receiving propofol infusion than in those receiving midazolam, although this did not influence satisfaction with the sedation. Thus, one does not need to consider intraoperative dreaming when choosing propofol or midazolam as a sedative drug in patients undergoing spinal anesthesia.
Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, 1 Hwayang-Dong, Gwanggin-Gu, Seoul, 143-701, South Korea. dikei@kuh.ac.kr
Duk-Kyung
DK
Kim
Young
Y
Joo
Tae-Yun
TY
Sung
Sung-Yun
SY
Kim
Hwa-Yong
HY
Shin
D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects; D016009:Chi-Square Distribution; D054810:Deep Sedation / Q000009:adverse effects; D004325:Dreams / Q000187:drug effects*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage* / Q000009:adverse effects; D007262:Infusions, Intravenous; D008297:Male; D008874:Midazolam / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D016017:Odds Ratio; D017060:Patient Satisfaction; D018579:Patient Selection; D015742:Propofol / Q000008:administration & dosage* / Q000009:adverse effects; D011446:Prospective Studies; D056910:Republic of Korea; D011795:Surveys and Questionnaires; D013997:Time Factors
D006993:Hypnotics and Sedatives; D008874:Midazolam; D015742:Propofol