Stait M L, Leslie K, Bailey R
Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, Victoria.
Anaesth Intensive Care. 2008 Sep;36(5):685-90. doi: 10.1177/0310057X0803600509.
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.
据报道，在接受全身麻醉苏醒期访谈的患者中，五分之一的患者会做梦，但在程序性镇静期间做梦的发生率、预测因素和后果尚不清楚。在这项前瞻性观察研究中，对200例接受静脉镇静下择期结肠镜检查的患者在苏醒期进行访谈，以确定做梦和回忆的发生率。镇静技术由麻醉师自行决定。做梦的发生率为25.5%。报告做梦的患者比未报告做梦的患者更年轻。做梦者和未做梦者之间咪达唑仑和芬太尼的剂量相似，然而，报告做梦的患者丙泊酚剂量高于未做梦的患者。患者报告的是关于日常生活的简短、简单的梦——没有梦提示对手术过程有濒死体验的回忆。4%的患者报告对手术过程有清晰回忆，这与相当于浅全身麻醉的丙泊酚剂量一致。回忆的唯一显著预测因素是较低的丙泊酚剂量。患者对护理的满意度普遍较高，然而，做梦者比未做梦者对护理更满意。
