[Analysis of implicit memory during propofol anesthesia].
OBJECTIVE: Consensus has not been achieved on the presence of unconscious memory of messages in general anesthesia for methodological reasons. Our objective was to apply a model of anesthesia that allows for clinical control of the level of hypnosis in order to evaluate the presence and characteristics of implicit memory in deep sedation with propofol. PATIENTS AND METHODS: We randomly assigned 48 consecutive patients undergoing lower limb surgery to two groups. In both groups subarachnoid anesthesia was with varying doses of propofol to maintain a level of hypnosis marked by inability to respond to orders, absence of movements and spontaneous ventilation. The experimental group listened to a recording of the words "banana" and "melon" for the semantic category of fruits and "white" and "black" for colors. The control group listened to a recording of environmental operating room noise. We recorded, among other variables, anxiety and age. Upon awakening, after the presence of conscious memory had been ruled out, we investigated implicit memory by comparing the percentage of correct answers in the two groups. RESULTS: The experimental group had a higher percentage of correct fruit names (p = 0.03). No differences were detected for colors. The youngest patients in the experimental group were correct more often about the fruits than were older members (p = 0.04) and those with greater anxiety were more often correct (p = 0.002). CONCLUSIONS: Implicit memory is preserved under hypnosis with propofol and is more likely to be present among those who are younger or experience greater anxiety. Concrete words with object references are more easily remembered than abstract words referring to perception. The semantic load of messages is relevant.