Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical Anesthesia
Authors' conclusion
This study demonstrates the feasibility of using a standardized anesthetic protocol in real-world clinical setting to facilitate anesthesia dreaming.
Study context
- Population
- Patients undergoing elective surgery anesthetized with a five-element propofol-based, EEG-guided emergence protocol to promote dreaming452 interviewed
- Participants
- 474 patients
- Exposure
- Dreamers vs nondreamers
- Outcome
- Feasibility: protocol adherence, dream recall, patient experience and safety
Methodological detailsstandardized protocol, preregistered subset analyses
- Standardized protocol
- Preregistered subset analyses
Main finding
As reported in the abstract
Dream recall and protocol adherence · Immediately after emergence
- Reported dreaming, all interviewed patients
- 69%
- Reported dreaming, full adherence to all elements (n = 57)
- 93%
- Adherence, verbal priming and propofol use
- 100%
- Adherence, EEG monitoring
- greater than or equal to 90%
- Adherence, immediate interviews
- 95%
- Adherence, no-stimulation emergence period
- 14%
Observational data: associations, not effects.
Further findings
Mean
| Outcome | Dreamers | Nondreamers | P value |
|---|---|---|---|
| Subjective sleep qualityHigher sleep quality in dreamers | 9.16 (SD 1.57) | 7.65 (SD 2.86) | P < 0.001 |
Dream recall with full adherence to all protocol elements (subgroup)
- Reported dreaming among 57 patients with full adherence
- 93%
Dream valence
- Positive dreams
- 86%
- No very negative dreams
Protocol adherence (feasibility)
- Verbal priming and propofol use
- 100%
- EEG monitoring
- greater than or equal to 90%
- Immediate interviews
- 95%
- No-stimulation emergence period (low)
- 14%
PACU outcomes: recovery times, analgesic and antiemetic use (breast cancer subset, preregistered)
- Did not differ between dreamers and nondreamers
Safety
- No intraoperative awareness
Original publication
Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical Anesthesia. Anesthesiology. Published 3 February 2026. doi:10.
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