A new five-step anesthesia protocol increased the likelihood of positive dreams, which may help reduce patient fear and improve emotional recovery after surgery.


RT’s Three Key Takeaways:

  1. Standardized Anesthesia Protocol: A five-step protocol designed to enable dreaming during emergence from general anesthesia resulted in 93% of patients reporting dream experiences when all steps were followed.
  2. Enhanced Patient Satisfaction: Patients who remembered dreaming during surgery rated their sleep quality significantly higher and reported a more positive overall experience than those who did not.
  3. Therapeutic Potential: Researchers suggested that the anesthetic experience could become part of the healing process, as prior cases show dreaming may reduce symptoms of depression, anxiety, and post-traumatic stress disorder.


Anesthesiologists may be able to safely increase the likelihood that patients dream during surgery to improve the overall surgical experience, according to a study published in Anesthesiology.

The study tested a standardized five-step anesthesia protocol designed to enable dreaming during emergence from general anesthesia. Among 452 patients interviewed after surgery, 69% reported dreaming. In a subgroup of 57 patients where all five elements of the protocol were followed, 93% reported dream experiences.

The protocol1 included:

  1. informing patients before surgery that they might dream
  2. using propofol as the anesthetic to bring patients back to consciousness
  3. monitoring brain activity with an electroencephalogram (EEG),
  4. minimizing stimulation for at least 10 minutes before bringing patients back to responsiveness, and
  5. interviewing patients immediately after waking.

“For many patients, anesthesia is the part of surgery they fear most,” said Boris D Heifets, study corresponding author and physician, in a news release. “These findings suggest that, with a simple and structured approach, anesthesiologists may be able to shape that experience in a more positive direction.”

The study found that most reported dreams were pleasant, with no very negative dreams reported. Patients who remembered dreams rated their sleep quality during anesthesia significantly higher than patients who did not recall dreaming.

Because more than 100,000 patients undergo general anesthesia each day in the US, the findings could open a new line of research into whether the anesthetic experience itself might become part of the surgical healing process, according to the study.

“We know from prior case reports that some patients have experienced reductions in post-traumatic stress disorder symptoms, depression, and anxiety following anesthetic dreams,” said Heifets. “The key ingredient may be as simple as a 10-minute period of quiet during emergence from anesthesia.”

The study authors noted that these findings could lay a foundation for studying whether anesthesia dreaming could eventually support emotional well-being, reduce anxiety, or improve satisfaction with the surgical experience and healthcare delivery.


Reference

  1. Sikka P, et al. Feasibility of a Multicomponent Protocol to Promote Dreaming during Surgical Anesthesia. Anesthesiology 145(1):p 21-36, July 2026. | DOI: 10.1097/ALN.0000000000005968