Brief report: the effect of suggestion on unpleasant dreams induced by ketamine administration

Anesth Analg. 2011 May;112(5):1082-5. doi: 10.1213/ANE.0b013e31820eeb0e. Epub 2011 Feb 23.


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.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Affect / drug effects
  • Anesthesia, Spinal
  • Chi-Square Distribution
  • Deep Sedation / adverse effects*
  • Dreams / drug effects*
  • Dreams / psychology*
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / adverse effects*
  • Ketamine / administration & dosage
  • Ketamine / adverse effects*
  • Male
  • Mental Recall / drug effects
  • Middle Aged
  • Republic of Korea
  • Suggestion*
  • Time Factors


  • Hypnotics and Sedatives
  • Ketamine