A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Subjective experiences during dexmedetomidine- or propofol-induced unresponsiveness and non-rapid eye movement sleep in healthy male subjects
Tekijät: Valli Katja, Radek Linda, Kallionpää Roosa .E., Scheinin Annalotta, Långsjö Jaakko, Kaisti Kaike, Kantonen Oskari, Korhonen Jarno, Vahlberg Tero, Revonsuo Antti, Scheinin Harry
Kustantaja: Elsevier Ltd
Julkaisuvuosi: 2023
Journal: British Journal of Anaesthesia
Tietokannassa oleva lehden nimi: British Journal of Anaesthesia
Vuosikerta: 131
Numero: 2
Aloitussivu: 348
Lopetussivu: 359
eISSN: 1471-6771
DOI: https://doi.org/10.1016/j.bja.2023.04.026
Verkko-osoite: https://www.doi.org/10.1016/j.bja.2023.04.026
Rinnakkaistallenteen osoite: https://research.utu.fi/converis/portal/detail/Publication/180251079
Background: Anaesthetic-induced unresponsiveness and non-rapid eye movement (NREM) sleep share common neural pathways and neurophysiological features. We hypothesised that these states bear resemblance also at the experiential level.
Methods: We compared, in a within-subject design, the prevalence and content of experiences in reports obtained after anaesthetic-induced unresponsiveness and NREM sleep. Healthy males (N=39) received dexmedetomidine (n=20) or propofol (n=19) in stepwise doses to induce unresponsiveness. Those rousable were interviewed and left unstimulated, and the procedure was repeated. Finally, the anaesthetic dose was increased 50%, and the participants were interviewed after recovery. The same participants (N=37) were also later interviewed after NREM sleep awakenings.
Results: Most subjects were rousable, with no difference between anaesthetic agents (P=0.480). Lower drug plasma concentrations were associated with being rousable for both dexmedetomidine (P=0.007) and propofol (P=0.002) but not with recall of experiences in either drug group (dexmedetomidine: P=0.543; propofol: P=0.460). Of the 76 and 73 interviews performed after anaesthetic-induced unresponsiveness and NREM sleep, 69.7% and 64.4% included experiences, respectively. Recall did not differ between anaesthetic-induced unresponsiveness and NREM sleep (P=0.581), or between dexmedetomidine and propofol in any of the three awakening rounds (P>0.05). Disconnected dream-like experiences (62.3% vs 51.1%; P=0.418) and memory incorporation of the research setting (88.7% vs 78.7%; P=0.204) were equally often present in anaesthesia and sleep interviews, respectively, whereas awareness, signifying connected consciousness, was rarely reported in either state.
Conclusions: Anaesthetic-induced unresponsiveness and NREM sleep are characterised by disconnected conscious experiences with corresponding recall frequencies and content.
Clinical trial registration: Clinical trial registration. This study was part of a larger study registered at ClinicalTrials.gov (NCT01889004).
Ladattava julkaisu This is an electronic reprint of the original article. |  |
