Leslie Kate, Skrzypek Hannah, Paech Michael J, Kurowski Irina, Whybrow Tracey
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, and Department of Pharmacology, University of Melbourne, Parkville, Victoria, Australia.
Anesthesiology. 2007 Jan;106(1):33-42. doi: 10.1097/00000542-200701000-00010.
Dreaming reported after anesthesia remains a poorly understood phenomenon. Dreaming may be related to light anesthesia and represent near-miss awareness. However, few studies have assessed the relation between dreaming and depth of anesthesia, and their results were inconclusive. Therefore, the authors tested the hypothesis that dreaming during anesthesia is associated with light anesthesia, as evidenced by higher Bispectral Index values during maintenance of anesthesia.
With approval, 300 consenting healthy patients, aged 18-50 yr, presenting for elective surgery requiring relaxant general anesthesia with a broad range of agents were studied. Patients were interviewed on emergence and 2-4 h postoperatively. The Bispectral Index was recorded from induction until the first interview. Dream content and form were also assessed.
Dreaming was reported by 22% of patients on emergence. There was no difference between dreamers and nondreamers in median Bispectral Index values during maintenance (37 [23-55] vs. 38 [20-59]; P=0.68) or the time at Bispectral Index values greater than 60 (0 [0-7] vs. 0 [0-31] min; P=0.38). Dreamers tended to be younger and male, to have high home dream recall, to receive propofol maintenance or regional anesthesia, and to open their eyes sooner after surgery. Most dreams were similar to dreams of sleep and were pleasant, and the content was unrelated to surgery.
Dreaming during anesthesia is unrelated to the depth of anesthesia in almost all cases. Similarities with dreams of sleep suggest that anesthetic dreaming occurs during recovery, when patients are sedated or in a physiologic sleep state.
麻醉后报告的梦境仍是一种了解甚少的现象。梦境可能与浅麻醉有关，并代表险些知晓。然而，很少有研究评估梦境与麻醉深度之间的关系，其结果尚无定论。因此，作者检验了这一假设，即麻醉期间的梦境与浅麻醉有关，麻醉维持期间更高的脑电双频指数值可证明这一点。
经批准，对300名年龄在18至50岁之间、同意接受择期手术且需要使用多种药物进行松弛性全身麻醉的健康患者进行了研究。在患者苏醒时及术后2至4小时进行访谈。记录从诱导直至首次访谈时的脑电双频指数。还评估了梦境内容和形式。
22%的患者在苏醒时报告有梦境。做梦者与未做梦者在麻醉维持期间的脑电双频指数中位数（37[23-55]对38[20-59]；P=0.68）或脑电双频指数值大于60的时间（0[0-7]对0[0-31]分钟；P=0.38）方面无差异。做梦者往往更年轻、为男性，在家时梦境回忆能力高，接受丙泊酚维持麻醉或区域麻醉，且术后睁眼较早。大多数梦境与睡眠中的梦境相似且令人愉悦，其内容与手术无关。
几乎在所有情况下，麻醉期间的梦境都与麻醉深度无关。与睡眠梦境的相似性表明，麻醉期间的梦境发生在恢复阶段，此时患者处于镇静状态或生理睡眠状态。
