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The effect of post-anaesthetic dreaming on patient acceptance of ketamine anaesthesia: A comparison with thiopentone-nitrous oxide anaesthesia

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Discussion and Conclusion

The mental disturbances following anaesthesia could be separated into two groups. The first kind, patients experienced before awakening. In most instances their content was not related to the hospital environment. Therefore one may refer to this group of mental disturbances as dreams.

The second group of mental disturbances was experienced by ketamine patients only. This occurred after the patient became aware of the recovery-room environment. They were misinterpretations of the surroundings and were entirely hospital related. These mental disturbances can be classified as illusions.

Our results confirm previous reports of a high incidence of dreaming and illusions after ketamine anaesthesia. These dreams were intensely colourful, highly impressive, of abstract or concrete content, and frequently unpleasantly disturbing to the patient.

Bésumé

Deux methodes d’anesthésie différentes ont été utilisées alternativement chez 100 malades consécutives subissant un avortement thérapeutique. Les unes ont recu 2 mg/kilo de Kétamine en induction, avec répétition de la moitié de cette dose au moment de la dilatation du col. Les autres ont reçu du Protoxyde d’azote à 70 pour cent aprés une induction au Thiopcnthane (5 mg/kilo); un tiers de la dose d’induction était répété au moment de la dilatation du col.

Dix mg de Dropéridol furent administrés a toutes les patientes une heure avant l’intervention. Les malades furent toutes revues 12 à 24 heures aprés l’anesthésie.

Cet interview a confirmé les conclusions d’autres auteurs, à savoir l’incidence elevee (60 pour cent) de rêves désagréables, (33 pour cent) d’hallucinations apres administration de Kétamine.

Ces chiffres ressemblent à ceux rapportés apres administration de Kétamine chcz des malades n’ayant pas reçu de prémédication.

Une malade sur trois s’objectait a recevoir à nouveau le même genre d’anesthésie en cas d’anesthésie future. Par ailleurs, toutes les malades anesthésiées au Thiopenthane, Protoxyde, avaient gardé un bon souvenir de leur anesthesie et etaient disposées à recevoir à l’avenir le même type d’anesthésie.

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Correspondence to Michael Krestow.

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Krestow, M. The effect of post-anaesthetic dreaming on patient acceptance of ketamine anaesthesia: A comparison with thiopentone-nitrous oxide anaesthesia. Canad. Anaesth. Soc. J. 21, 385–389 (1974). https://doi.org/10.1007/BF03006072

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Keywords

  • Ketamine
  • Thiopentone
  • CANADIAN Anaesthetist
  • Droperidol
  • Keta