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The Effect of Suggestion on Unpleasant Dreams Induced by Ketamine Administration

Soon Ho Cheong, Kun Moo Lee, Se Hun Lim, Kwang Rae Cho, Myoung Hun Kim, Myoung Jin Ko, Joo Cheol Shim, Min Kyung Oh, Yong Han Kim, Sang Eun Lee

Anesthesia & Analgesia February 25, 2011 DOI: 10.1213/ane.0b013e31820eeb0e (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 100
Population Patients receiving ketamine sedation for a procedure
Intervention Ketamine
Measures pleasantness/unpleasantness scale (grade 1 very unpleasant to grade 5 very pleasant)
Topics Esketamine Ketamine
Citations 29
Key findings Among patients who lost consciousness, a pre-sedation positive suggestion was associated with fewer unpleasant dreams (0% vs 8%) and more pleasant dreams (54% vs 22%) compared with no suggestion (P=0.01), but in the intent-to-treat population overall dream-mood frequencies were similar between groups. The authors suggest positive suggestion may help reduce recall of unpleasant dreaming with ketamine sedation.

Abstract

The use of ketamine may be associated with the recall of unpleasant dreams after sedation. We hypothesized that a positive suggestion before sedation could reduce the incidence of ketamine-induced unpleasant dreams. To test this hypothesis, we randomized 100 patients receiving sedation with ketamine for their procedure into 2 groups with 1 group having an anesthesiologist provide a mood-elevating suggestion to the patient before ketamine administration (suggestion group), whereas in the control group no suggestion was provided. Patients were provided with a pleasantness/unpleasantness scale to rate "the overall mood of the dream" as very unpleasant (grade 1), quite unpleasant (grade 2), neither or mixed (grade 3), quite pleasant (grade 4), and very pleasant (grade 5). In those patients who lost consciousness, the frequencies of grades 1, 2, 3, 4, and 5 were 0%, 0%, 46%, 24%, and 30% in the suggestion group and were 6%, 2%, 70%, 12%, and 10%, respectively, in the control group (P=0.01). In the intent-to-treat population the overall frequency between groups was very similar. This study implies that when administering ketamine as part of a sedation regimen, positive suggestion may help reduce the recall of unpleasant dreaming.

Comparable studies

Other randomized controlled trials on ketamine, most cited first.

Study Year Design Participants
Subanesthetic Effects of the Noncompetitive NMDA Antagonist, Ketamine, in Humans Healthy human subjects recruited from the community 1994 Randomized controlled trial n = 19
Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial Patients with treatment-resistant major depression experiencing a major depressive episode 2013 Randomized controlled trial n = 73
Remifentanil-induced Postoperative Hyperalgesia and Its Prevention with Small-dose Ketamine Patients undergoing major abdominal surgery 2005 Randomized controlled trial n = 75
Efficacy of Intravenous Ketamine for Treatment of Chronic Posttraumatic Stress Disorder Patients with chronic PTSD related to a range of trauma exposures 2014 Randomized controlled trial n = 41
Ketamine-Induced Deficits in Auditory and Visual Context-Dependent Processing in Healthy Volunteers Healthy volunteers 2000 Single-blind placebo-controlled study n = 20

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Esketamine Ketamine Dreaming Lucid dreaming Philosophy of mind