The Effect Of Different Anesthetic Drugs, Types Of Operations And Gender On The Dreaming And The Possible Mechanisms

Background General anesthesia drugs sevoflurane and propofol are used hypnotic for the patients during outpatient surgeries with the shortest onset time and intermediate duration of action and cardiovascular stability in the clinical use. Sedation with sevoflurane and propofol are often performed to alleviate the sufferings of the patient and increase patient acceptance or the degree of comfort of surgeries, improve surgical conditions, or prevent the recall of unpleasant events during surgery. However, deaming during sedation or anesthesia with sevoflurane and propofol is a common. Dreaming is sometimes distressing to patients and may decrease satisfaction with care. To date, the difference between the upper gastrointestinal endoscopy and the first-trimester surgical abortion in the incidence of dreaming for short procedures has not been compared. So the objective of the study is to observe different anesthetic drugs, types of operations and gender influence on the dreaming during sevoflurance or propofol short-term sedation and given to contribute to the useage of the clinic.Objective To study the potentiation effect and the possible mechanisms of the dreaming during sevoflurane or propofol short-term sedation in the first-trimester surgical abortion. To study the potentiation effect of the situation of different organ specific procedures on the dreaming during short propofol sedation in the first-trimester surgical abortion. To study the potentiation effect and the possible mechanisms of the dreaming under the gender differences during short propofol sedation in the upper gastrointestinal endoscopy. To investigates whether dreaming is affected by recovery time and and whether the incidence of dream, dream content or nature and choice of sedative drug affect patient satisfaction with sedation.Methods Patients undergoing upper gastrointestinal endoscopy or first-trimester surgical abortion were screened. All participants were divided into different groups according to the different studies. Anesthesiologists were instructed to target the depth of sedation using an Observer’s Assessment of Alertness/Sedation (OAA/S) score. Patients were interviewed immediately after they emerged from sedation and orientated to time, place and person using the modified Brice questionnaire to evaluate the incidence of dreaming. If dreaming was reported, and the dreamers were immediately asked to complete a five-point Likert scales regarding the dream. The dream content, the incidence of dream and satisfaction were also assessed.Results In the first-trimester surgical abortion during short-term sedation with sevoflurane or propofol:the incidence of dreaming was significantly different between sedative groups with60%(60/100) of the sevoflurane group and33%(33/100) of the propofol group (p=0.000). However, recovery time did not significantly differ between groups. In the sevoflurane group, a greater number of dreamers could not recall what they had dreamed about (p=0.02) and more patients reported dreams that had no sound (p=0.03) or movement (p=0.001) compared with dreamers in the propofol group. Most participants reported dreams with positive emotional content, patients had the higher satisfaction and these did not significantly differ between two groups. There were no significant differences in satisfaction with sedation care between the dreamers and the non-dreamers. In the first-trimester surgical abortion and the upper gastrointestinal endoscopy during propofol short sedation. There were significant differences in the incidence of dream between the two groups. The proportions of dreamers were18%(18/100) in group Ⅰ and33%(33/100) in group Ⅱ (p=0.015) despite similar recovery time. Most dreams were simple, meaningful and had no significant sexual content during propofol short sedation. Patient higher satisfaction was comparable between the two groups.In the operation of the upper gastrointestinal endoscopy during propofol short-sedation. There were significant differences in the incidence of dream between the male group and female group. The incidence of dreaming was significantly higher in men (31%) than in women (17%)(P=0.02), but recovery time was similar. In males,45%(14/31) of dreamers reported positive emotional content and only6%(2/31) reported negative emotional content. In contrast, in females,18%(3/17) were positive and29%(5/17) were negative (P=0.04). Males reported dreams that were more vivid, meaningful, familiar and memorable (P<0.01). No significant gender differences were observed in the emotional intensity of dreams, and emotional content of the dream did not influence patients’satisfaction. Patient had the higher satisfaction with sedation care between the two groups.Conclusion The incidence of dreaming was not affected by recovery time during sevoflurane or propofol short-term sedation. The incidence of dreaming was significantly higher in patients administered sevoflurane than in those administered propofol during first trimester surgical abortion. Patient satisfaction was not influenced by sedative and/or by the occurrence of dreaming during sevoflurane or propofol short-term sedation. Therefore, anesthetic choice for patients undergoing first-trimester abortion is trivial.Different organ specific procedures could affect the incidence of dreaming intrasedation. First-trimester surgical abortion did increase the incidence of dreaming during propofol short sedation. Most dreams were simple and pleasant, about everyday life, no significant sexual dreams and no influence on patient’s satisfaction.Gender differences were found in the incidence and content of dreams during short propofol sedation, despite similar recovery times. Specifically, males reported dreaming more frequently and had a higher incidence of recall for their dream narratives. Males reported significantly more positive emotional content, less negative emotional content and more meaningful content. However, male and female dreamer postoperative satisfaction was no significant difference. Patient satisfaction was not influenced by gender or the occurrence of dreaming during propofol short-sedation.