Some patients can obtain clear and detailed information Sexual hallucinations during anesthesia with sedative-hypnotics Propofol, midazolam, diazepam, nitrous oxide, etc. Some may make provocative or sexual comments or do things, such as grabbing or kissing health care workers or touching themselves in a sexual manner. Some people wake up mistakenly believing they have been sexually assaulted. Why does this happen?
Doctors have known this for a long time sedative hypnotic, which slows down brain activity and induces calmness and sleep, which can affect a patient’s perception of reality. In his 1984 review of the drugs midazolam, ketamine, and thiopental, he found that 18% of patients undergoing anesthesia for dental or medical procedures had symptoms such as: Difficulty distinguishing between reality and fantasy During and immediately after administration. Similarly, a 1980 study found that approximately 14% of patients reported some symptoms. sexual dreams and excitement while under anesthesia. It is no wonder that these two characteristics of anesthesia can appear together as sexual hallucinations.
In rare cases, healthcare workers become infected. Taking advantage of the patient’s unconscious state to commit sexual assault. For example, in 1991, a medical professional sexually assaulted a college student under anesthesia. The case was initially dismissed on the basis that the patient may have been suffering from drug-induced hallucinations, but genetic evidence left behind by medical experts later led to the conviction. It is unlikely that all reported sexual assaults under anesthesia are due to sexual hallucinations.
we Pharmacology researcher Who these days? examined medical literature An investigation into sexual assault or fantasies during anesthesia from the earliest recorded case to February 2023 found 87 reported cases from 17 published articles. A better understanding of what causes disturbing or sexual dreams under anesthesia could help researchers find ways to reduce the risk of hallucinations to keep both patients and health care providers safe. there is a possibility.
Reports of sexual hallucinations
16 of the individual cases Our study involved patients reporting sexually amorous behavior and perceptions of sexual assault. In these cases, observers such as medical professionals or family members were also present during the procedure, making it less likely that the sexual behavior actually occurred due to hallucinations.
They also found a significant correspondence between the anatomical location of the procedure and where patients perceived inappropriate sexual contact. Treatment with the mouth was recognized as oral sex, squeezing the balls to facilitate access to the veins was considered squeezing the penis, treatment with the chest was considered breast fondling, and treatment with the groin was considered vaginal penetration.
This might explain why One evaluation of 200 patients No cases of sexual hallucinations were found in patients who underwent abdominal surgery for the gallbladder or appendix, but about 12% of patients who underwent vaginal surgery noted amorous or sexually uninhibited behavior. did.
Trauma for both patients and healthcare workers
These effects of anesthesia can have significant real-world implications for patients and healthcare providers long after surgery.
of emotional turmoil The harm suffered by a patient is likely to be the same whether he actually experiences a sexual assault while under anesthesia or experiences vivid hallucinations of the event. And practitioners can also experience pain. some medical professionals Accusations of actual or suspected sexual assault will be taken to a regulatory commission or court and the business license will be revoked.
If the patient knows before undergoing anesthesia that hallucinations of sexual assault, although rare, are a possible side effect of anesthesia, and what steps are the provider taking to reduce that risk? If you know, you may be less likely to believe in sexual assault. The hallucination was real. However, this does not make hallucinations any less traumatic.In one case, an anesthesiology student volunteered for research She experienced sexual hallucinations after taking sedative-hypnotic drugs. She knew that her vivid memories of her sexual assault were not real, but the pain she felt in response to them caused her to withdraw from her research.
After reviewing the literature, we found the following: 71 individual cases The health care professional was alone with the patient at the time the sexual assault or act allegedly occurred. For the safety and health of both patients and medical professionals, having witnesses present and recording devices during dental and medical procedures prevents opportunities for sexual assault and prevents patients from experiencing It may help reassure people that the hallucinations are not real.
But health systems must go further to protect patients. Patients suffering from the trauma of a hallucinated sexual assault should be referred for counseling, as would anyone who suffered physical injury during a medical or dental procedure, even if there is evidence that it did not actually occur. and should be supported.
Many things remain unclear.
It’s unclear why some people are more likely to recall dreams under anesthesia. A 2009 study of 97 patients receiving propofol found that I often remember my dreams After receiving a higher dose of anesthetic, he was under 50 years old and took longer to recover from anesthesia. A 2013 study of 200 patients receiving propofol found that men were more likely to experience: I remember dreams after anesthesia However, women were more likely to remember unpleasant dreams. Dreams and hallucinations are related experiences, but the person experiencing the hallucination believes that it could be real.
Although we have reviewed all cases of sexual hallucinations published in the medical literature, the actual incidence of anesthesia-induced sexual hallucinations remains unknown. Given that decades have passed since the first cases were reported, more efforts are needed. Understanding the prevalence of sexual hallucinations under anesthesia will require data from very large sample sizes of patients. However, drug companies are reluctant to invest in research that shows their drugs can cause harmful side effects.
Finally, although we limited our review to reports of sexual hallucinations during anesthesia, millions of Americans use other prescription sedative-hypnotics. Benzodiazepines Others, such as alprazolam (Xanax) and temazepam (Ristril), are used to treat anxiety and induce sleep. Z drag Other drugs used to induce sleep include zolpidem (Ambien), eszopiclone (Lunesta), suvorexant (Belsomra), and sodium oxybate (Xyrem). opioid such as morphine and oxycodone, Gabapentinoid Drugs such as gabapentin (Neurontin) and pregabalin (Lyrica) are used to treat pain. muscle relaxant Drugs such as carisoprodol (Soma) and cyclobenzaprine (Flexeril) are used for muscle spasms. There have been reports of patients experiencing hallucinations while taking any of these drugs.
In the review of FDA Adverse Event Reporting SystemThe study, which is used by public health officials and researchers to monitor drug safety, reported 30,728 “abnormal dreams” from 1974 to 2022. Most of them concerned sedative-hypnotic drugs that treat insomnia, anxiety, pain, and muscle spasms. The report did not specify the nature of these dreams or how they affected the patients’ own sense of well-being.
It is important for patients to be aware that they may have unusual dreams when starting sedative-hypnotics and to inform a health care professional if they experience hallucinations. These symptoms may indicate that the drug is not the right choice for you or that the dose is too high.
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