Effect of Penehyclidine on Dreaming Occurrence and Plasma Acetylcholine Variation During Propofol Anesthesia for Minor Gynecological Surgery

Background: Dreaming often occurs during anesthesia especially with using propofol, which is a poorly understood phenomenon on the basis of current available data. The present study aimed to determine whether penehyclidine can inhibit propofol anesthesia-related dreaming and evaluate the relationship between acetylcholine and propofol-induced dreaming. Methods: Healthy women undergoing elective minor gynecological surgery were randomized to receive penehyclidine hydrochloride 0.01 mg/kg (penehyclidine group, n = 200) or the same volume of saline (saline group, n = 200) at 10 min before propofol injection. Immediately after surgery, blood samples of the women were collected to determine the plasma acetylcholine concentrations. Interviews concerning dreaming incidence, contents, as well as how she felt her dream (pleasant, neutral, or unpleasant) were conducted 3-5 minutes after she could speak out her name and take appropriate action according to the observer’s instruction. Results: Penehyclidine did not affect dreaming incidences when compared with saline (39.0% vs. 47.5%, P = 0.086). There was no significant difference with respect to the age, weight, propofol dose, or surgery duration between penehyclidine group and saline group, as well as between dreamers and non-dreamers in the saline group. There was no significant difference with respect to the plasma acetylcholine concentrations between dreamers and non- dreamers in the saline group.  Sixty-five women (68.0%) recalled the contents of dreams among which 39 (60.0%) were pleasant. Women who recalled dream contents had higher plasma concentrations of acetylcholine than women who did not (P = 0.000). Conclusion: Penehyclidine cannot reduce the dreaming incidence in women during propofol anesthesia. But, the dreamers who can recall the dreaming contents during propofol anesthesia have higher plasma levels of acetylcholine. (Funded by National Natural Science Foundation of China; Chinese Clinical Trial Registry number, ChiCTR-TRC-14005033.)     Citation: Shi-Xia Xu, Zhen-Zhen Zhang, He-Liang Sun, Jian-Jun Yang. Effect of penehyclidine on dreaming occurrence and plasma acetylcholine variation during propofol anesthesia for minor gynecological surgery. J Anesth Perioper Med 2017; 4: 108-13. doi: 10.24015/JAPM.2017.0023 This is an open-access article, published by Evidence Based Communications (EBC). This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium or format for any lawful purpose. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.