In the past it has been discussed how in rare occasions patients (mostly young women) while having wisdom teeth surgery are sexually assaulted. This is discussed at http://www.teethremoval.com/sexual_assault_under_anesthesia_for_wisdom_teeth_removal.html and in several blog posts such as In Light of the Allegations of Child Sex Abuse at Penn State…, Dentist Who Groped Patients Sentenced to Jail, and Recent Cases of Dentist Assistant Sexual Assault During Wisdom Teeth Removal. Many times these patients go on to sue either the dental assistance or dentist or oral surgeon who committed the sexual assault. However, most of these same patients are given drugs during the surgery that can cause sexual hallucinations. Thus it is typical for the legal team defending the dental assistance or dentist or oral surgeon to argue that the patient was dreaming and no actual sexual assault occurred. In some cases it is plausible that the dental assistance or dentist or oral surgeon commits sexual assault but is wrongly found innocent while in other cases it is plausible the dental assistance or dentist or oral surgeon does not commit any sexual assault and the patient experiences a sexual hallucination but the dental assistance or dentist or oral surgeon is wrongly found guilty. Thus it has been suggested for a long time on this site that nurses or other chaperones should be present during wisdom teeth surgery when any of such medications are given so that it is clear if a hallucination or a sexual assault took place.
Additional guidance on such scenarios is presented in the article titled “Sexualbezogene Halluzinationen und Träume unter Anästhesie und Sedierung” writtten by Schneemilch et al. appearing in Der Anaesthesist (vol. 61, no. 3, pp. 234–241, Mar. 2012) which should be expanded on. Note that this article is German which has been machine translated to English so there may be errors in the translation. According to the article by Schneemilch these additional witnesses such as the nurses or other chaperones referred to as above should ideally be the same gender as the patient undergoing the surgical procedure. Furthermore, the names of these witnesses should be recorded in the patient record after surgery in case any later dispute arises. The article by Schneemilch also suggests additional studies should be conducted to explore the incidence of hallucinations after anesthesia. The authors state:
“Since no spontaneous reports of sexual hallucinations are to be expected from the vast majority of patients, large prospective studies are necessary to determine the actual incidence, in which a targeted postoperative questioning of dreams, dream quality and hallucinations takes place taking into account the procedure, duration of intervention and anesthetics used.”
There was a study conducted by Chikkahanumanthappa et al. titled “A comparative study of sedation with dexmedetomidine or midazolam during spinal anesthesia,” Anesthesia Pain & Intensive Care (vol. 20, no. 3, Jul.-Sep. 2016) which compared dreams between two types of anesthesia dexmedetomidine and midazolam during elective spinal surgery. In the article by Chikkahanumanthappa 120 patients were included with 60 patients in each group receiving the two types of anesthesia. The patients were interviewed at the end of the surgery and also 30 minutes later in the recovery room to determine the incidence of dreams. The authors found for those who received midazolam that 10 patients or 16% experienced dreams while for those who received dexmedetomidine 2 patients or 3% experienced dreams. In the discussion of the article by Chikkahanumanthappa they mention a prior study (Kim et al. “Dreaming in sedation during spinal anesthesia: a comparison of propofol and midazolam infusion,” Anesthesia & Analgesia, vol. 112, no. 5, pp. 1076-1081, May 2011) that gave propofol or midazolam for deep sedation during spinal anesthesia and found 39.8% of those who received propofol experienced dreams and 12.1% of those who received midazolam experienced dreams. Furthermore in the article by Chikkahanumanthappa a prior study is mentioned (Stait et al. “Dreaming and recall during sedation for colonoscopy,” Anaesthesia & Intensive Care, vol. 36, no. 5, pp. 685-690, Sep. 2008) of sedation given for colonscopy where patients were given a combination of midazolam and/or fentanyl and/or propofol for sedation and 25.5% of the patients were reported to experience dreams. However no dreams of a sexual nature were reported in any of these studies.
In an old article by John W. Dundee in 1992 titled “Advantages and Problems with Benzodiazepine Sedation,” appearing in Anesthesia Progress (pages 132-137) the frequency of experiencing sexual fantasies after being giving midazolam was in the range from 1 in 50,0000 to 1 in 100,000 but this was based off of four centers in 1986 and 1987. In a study by Brandner et al. titled “Dreams, images and emotions associated with propofol anaesthesia,” appearing in Anaesthesia in 1997 (vol. 52, pp. 750-755) the authors attempted to determine the incidence and content including sexual content of dreaming during anesthesia. In the study by Brander the authors conducted a study of 120 patients having varicose vein surgery and found two patients given total intravenous anaesthesia with propofol had dreams of a sexual nature, one patient given propofol induction followed by maintenance of anaesthesia with nitrous oxide and isoflurane had a dream of a sexual nature, and two patients given thiopentone induction followed by maintenance of anaesthesia with nitrous oxide and isoflurant had dreams of a sexual nature. Thus 5 patients of the 120 patients in the study or 4.16% had dreams of a sexual nature. Thus it would appear that additional studies are needed with large sample sizes to better study dreams during surgery when anesthesia is given and how often dreams of a sexual nature occur. Perhaps such studies could help prevent additional cases of sexual assault during wisdom teeth extractions from occurring.