Dreaming Under Anesthesia May Make Surgery Feel Less Scary, Study Finds

CHICAGO — A new study suggests anesthesiologists may be able to safely increase the likelihood that patients dream during surgery — and that those dreams are typically positive, calming and associated with a better overall surgical experience.

In the study, published in the July issue of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA), the authors tested a standardized five-step anesthesia protocol designed to enable dreaming during emergence from general anesthesia. Among 452 patients who were interviewed after surgery, 69% reported dreaming. In the subgroup (57 patients) where all five elements of the protocol were followed, 93% reported dream experiences.

The protocol included telling patients before surgery that they might dream, using propofol as the anesthetic to bring patients back to consciousness, monitoring brain activity with EEG, minimizing stimulation for at least 10 minutes before bringing patients back to responsiveness, and interviewing patients immediately after waking. The study found most reported dreams were pleasant, with no very negative dreams reported, and 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 United States, the study’s corresponding author Boris D. Heifets, M.D., Ph.D., noted that the findings could open a new line of research into whether the anesthetic experience itself might become part of the surgical healing process.

“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 Dr. Heifets. “The key ingredient may be as simple as a 10-minute period of quiet during emergence from anesthesia.”

The authors note that this study could lay a foundation for studying whether anesthesia dreaming could eventually support emotional well-being, reduce anxiety, or improve satisfaction with the surgical experience.

"For many patients, anesthesia is the part of surgery they fear most," said Dr. Heifets. "These findings suggest that, with a simple and structured approach, anesthesiologists may be able to shape that experience in a more positive direction."

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 60,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. Follow ASA on Facebook, X, Instagram, Bluesky, and LinkedIn.

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