Adams D C, Hilton H J, Madigan J D, Szerlip N J, Cooper L A, Emerson R G, Smith C R, Rose E A, Oz M C
Department of Anesthesiology, Columbia-Presbyterian Medical Center, New York, NY, USA.
Circulation. 1998 Nov 10;98(19 Suppl):II289-92; discussion II292-3.
Many anesthetic drugs have been shown to disrupt conscious recall (explicit memory) in volunteers. However, unconscious processing (implicit memory) of intraoperative auditory material may occur during general anesthesia and may provide an opportunity for intraoperative therapeutic intervention. In this study, we examined patients undergoing elective cardiac surgery for evidence of intraoperative implicit and explicit memory.
Twenty-five subjects provided written informed consent and underwent general anesthesia and cardiopulmonary bypass for cardiac surgery. During the operation, patients were randomized to receive 1 of 2 different audiotapes of associated word pairs. Postoperatively, a blinded observer conducted a standardized interview to determine the extent of intraoperative implicit and explicit memory. With the use of free association, significant intraoperative implicit memory was found. In contrast, no patient had spontaneous or directed recall of intraoperative events, and we did not find evidence of intraoperative explicit memory with a recognition task.
Patients undergoing general anesthesia for cardiac surgery were reliably able to reinforce associations between word pairs solely on the basis of their intraoperative presentation. This provides further evidence that patients are capable of processing intraoperative auditory information.
许多麻醉药物已被证明会干扰志愿者的有意识回忆（外显记忆）。然而，术中听觉材料的无意识加工（内隐记忆）可能在全身麻醉期间发生，这可能为术中治疗干预提供机会。在本研究中，我们检查了接受择期心脏手术的患者，以寻找术中内隐和外显记忆的证据。
25名受试者提供了书面知情同意书，并接受了全身麻醉和心脏手术的体外循环。手术期间，患者被随机分配接受2种不同的相关单词对录音带中的1种。术后，一名盲法观察者进行了标准化访谈，以确定术中内隐和外显记忆的程度。通过自由联想，发现了显著的术中内隐记忆。相比之下，没有患者能自发或经引导回忆起术中事件，并且我们通过识别任务未发现术中存在外显记忆的证据。
接受心脏手术全身麻醉的患者仅根据术中呈现就能可靠地强化单词对之间的关联。这进一步证明患者能够加工术中听觉信息。
