Anesthesia Can Cause Disturbing Hallucinations, Lasting Trauma, UConn Researchers Find

“For the safety and well-being of both patients and medical professionals, having witnesses in the room or recording devices during dental or medical procedures could help prevent an opportunity for sexual assault and reassure patients that the hallucinations they may experience are not real,” according to a recommendation by University of Connecticut researchers Melody White, Ph.D. Candidate in Pharmaceutical Sciences and C. Michael White, Department Head & Distinguished Professor of Pharmacy Practice, as described in an article published this week by UConn Today.

“However,’ the researchers stressed, “the health care system needs to go further to protect patients. Patients struggling with the trauma of hallucinated sexual assault, even if there is evidence that it did not occur in reality, should be referred to counseling and supported just like someone who was physically harmed during a medical or dental procedure.”

The pharmacology researchers “recently reviewed the medical literature on sexual assault or sexual fantasy during anesthesia from the earliest documented case to February 2023, finding 87 reported cases from 17 published papers,” the UConn Today article reported. Doctors have long known that sedative-hypnotic drugs, which slow down brain activity to induce calm or sleep, can affect a patient’s perception of reality, the article noted.

The researchers pointed out that “Better understanding what triggers unpleasant or sexual dreams under anesthesia could help researchers figure out how to reduce the risk of hallucinations to keep both patients and providers safe.”  And while sexual dreams under anesthesia have been repeatedly documented, the researchers also noted that “It cannot be assumed that all cases of reported sexual assault under anesthesia are due to a sexual hallucination.”

Informing patients that such hallucinations are a possible side effect from sedative-hypnotic drugs like propofol, midazolam, diazepam and nitrous oxide, could make a difference, the article notes, stating that “It is possible that if patients knew a hallucination of sexual assault is a rare but possible adverse effect of anesthesia before they receive it, and were aware of the steps medical providers are taking to reduce that risk, they would be less likely to believe their sexual hallucinations were real. But this would not lessen the trauma of the hallucination.”

The emotional turmoil a patient undergoes is likely the same whether actually experiencing sexual assault under anesthesia or having vivid hallucinations of the event, the UConn Today article explained. And practitioners too can experience distress: Some medical professionals accused of real or perceived sexual assault have been brought before regulatory boards or the courts and lose their license to practice.

The researchers indicated that “data from a very large sample size of patients will be required to understand the prevalence of sexual hallucinations under anesthesia. However, drug companies are reluctant to spend money on research that may show that their drugs cause adverse side effects.”

In the meantime, the UConn researchers recommend, “It is important for patients to be aware that abnormal dreaming is a possibility when starting a sedative-hypnotic medication, and to inform their health professional if they experience hallucinations. These symptoms could indicate that the drug is not the right choice for you or that the dose may be too high.”