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Memory Priming in General Anesthesia

Memory Priming for Abstract and Concrete Words in General BIS Guided Propofol vs. Sevoflurane Anesthesia

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03727464
Enrollment
102
Registered
2018-11-01
Start date
2013-01-07
Completion date
2016-09-15
Last updated
2019-09-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Unconscious (Psychology)

Keywords

Memory priming, Anesthesia, Language processing, Abstract and Concrete words, Neural correlates

Brief summary

Memory priming under general anesthesia is a phenomenon of incredible interest in the study of consciousness and unconscious cognitive processing, and for clinical practice. However results from anesthesiological literature are divergent and methodologies vary. To overcome these limits, the present study aims at better defining the phenomenon of memory priming under general anesthesia, manipulating as experimental variables both the anesthetic drug used and the stimuli primed.

Detailed description

Some patients may develop serious psychological sequelae after surgical intervention under general anesthesia due to implicit memory formation of intraoperative events. A number of studies in the field of anesthesiology have tried to better define the phenomenon of implicit memory in general anesthesia, with conflicting results. While some studies demonstrated the existence of unconscious memory formation also under adequate general anesthesia (BIS ranging 40-60), others state that implicit memory formation is possible only during light sedation, and that, therefore, traumatic disorders due to unconscious intraoperative memories are imputable to inadequate anesthesiological intraoperative management. The methodologies used by these studies, however, are very heterogeneous, and often inaccurate from a cognitive point of view. Data from cognitive neuroscience, in fact, demonstrate that different linguistic material, e.g. abstract and concrete words, are processed and retrieved via different networks in the brain. Then, since different anesthetics are known to target different areas of the brain, it is assumable that implicit memory formation is influenced both by the specific drug used and by the type of stimuli primed. Therefore in this experiment, the investigators aim at testing implicit memory for different word category, abstract vs. concrete words, in patients undergoing either propofol or sevoflurane general anesthesia. Also, a very strict methodology was used both for the construction of the stimuli and the stimulation and testing procedure, in order to maximize the priming effect and exclude the risk of false positive results. The investigators hypothesize that, considering the existing data on propofol and sevoflurane effects on the brain, and the known neural correlates for abstract and concrete word processing, the priming effect would be different for abstract and concrete words between patients under propofol or sevoflurane anesthesia.

Interventions

BEHAVIORALAbstract priming

Patients were primed with a list of abstract during their general anesthesia

BEHAVIORALConcrete priming

Patients were primed with a list of concrete during their general anesthesia

BEHAVIORALControls

Patients did not receive any specific stimulation with words during their general anesthesia

DRUGPropofol

Propofol general anesthesia

DRUGSevoflurane

Sevoflurane general anesthesia

Sponsors

University of Milano Bicocca
CollaboratorOTHER
Fondazione I.R.C.C.S. Istituto Neurologico Carlo Besta
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

* patient undergoing general anesthesia for back surgery * American Society of Anesthesiology (ASA) physical status classification I or II * Italian native speaker * right handed (assessed with the Edinburgh Handedness Inventory) * not to suffer from memory deficits, hearing impairment or any other medical/psychiatric condition that could affect the memory performance or hearing

Exclusion criteria

* to develop a postoperative cognitive dysfunction or delirium or any other medical complication that could prevent the memory testing or that could affect memory performance

Design outcomes

Primary

MeasureTime frameDescription
Implicit score24 hoursImplicit memory is tested through a word stem completion test, in which the participant has to complete a three-letter stem with the first word that comes to mind. The completion test comprises both target stems (stems of word primed intra-operatively) and foils. The number of correct completions of target stems and foils is recorded as target and non target hits. The implicit score is then calculated as (target hits - nontarget hits)/total target stimuli. The score can therefore range (absolute values) from -1 to +1, where a positive score indicates memory priming.

Secondary

MeasureTime frameDescription
Explicit recall of intraoperative wordsbefore discharge from the Recovery Room and at 24 hoursThe number of intraoperative primed words that the patient is able to recall without any cue
Explicit recall of intraoperative eventsbefore discharge from the Recovery Room and at 24 hoursThe explicit recall of intraoperative events assessed with the Brice Interview
Target hits24 hoursThe number of correct stem completions (hits) with target words (i.e. words heard intraoperatively)
Nontarget hits24 hoursThe number of correct stem completions (hits) with nontarget words (i.e. words not heard intraoperatively)

Countries

Italy

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 16, 2026