The Incidence of Dreaming During General Anesthesia in Gynecological Surgeries; A Report from a Teaching Hospital Northern Iran

Background: Propofol, the most commonly used anesthetic agent in general anesthesia (GA), has frequently been associated with dreaming and hallucinations. These experiences may lead to serious psychological distress for patients and result in complaints against medical practitioners.

Objectives: This study aimed to investigate the incidence and characteristics of dreaming in gynecological surgeries performed under GA with propofol in a teaching referral center.

Methods: This cross-sectional analytical study was conducted at Al-Zahra Hospital in 2023. Participants were fully informed about the study's purpose and the confidentiality of their data, and written consent was obtained. After full recovery from anesthesia, once hemodynamic stability and pain control were achieved, a checklist was completed to document demographic data, intraoperative dreaming, and dream content.

Results: A total of 171 patients with a mean age of 40.4 ± 10.83 years and a mean Body Mass Index (BMI) of 27.26 ± 2.8 participated in the study. The incidence of dreaming was 6.4%. Most participants were married (162, 94.7%) and had no history of GA (106, 62%). The most common procedure was hysteroscopy (42.7%), while vaginal hysterectomy was the least common (6.4%). No statistically significant association was found between the type of surgery and intraoperative dreaming (P = 0.806) or dream content (P = 0.091). The most frequently reported type of dream was "unremembered and vague," with one case of tactile dreaming. Statistically significant associations were observed between dreaming and younger age (P = 0.02), history of GA (P = 0.015), and higher BMI (P = 0.0001).

Conclusions: Based on these results, it seems that the dreaming status during GA in gynecological surgeries at this center was acceptable. However, given the gender match in most cases and the report of one case of tactile hallucination, further investigation is recommended to mitigate adverse outcomes for patients and practitioners.