Personalized Music, Dreaming During Propofol Sedation

Dreaming during intravenous propofol sedation is common and may influence how patientsremember their perioperative experience. External auditory stimulation can sometimes beprocessed during sedation and may be incorporated into dream content. Music is apractical auditory intervention because it can be delivered through headphones withoutinterfering with anesthetic care or the surgical workflow. However, it remains unclearwhether music itself increases dream recall during propofol sedation, and whetherpatient‐selected music provides additional benefit beyond exposure to music with similaracoustic features.The modified Brice interview will be administered as soon as the participant hasadequately recovered consciousness and is able to communicate in the PACU. Because dreamrecall may fade over time, the interview will be conducted at the earliest feasible timepoint after recovery of consciousness and no later than 60 minutes after PACU arrival.This single‐center, parallel‐group, three‐arm randomized controlled trial will comparethree auditory conditions during propofol sedation: preferred music, matchednon‐preferred music, and silence. Participants assigned to the preferred music group willlisten to one personally selected track through closed‐back headphones. Participantsassigned to the matched non‐preferred music group will listen to a pleasant butnon‐selected track matched to the preferred music by genre family, tempo, and loudness.Participants assigned to the silence control group will wear identical closed‐backheadphones without music playback. In all groups, the assigned auditory condition willbegin shortly before sedative administration and continue until the end of the sedationperiod.The study population will consist of adults undergoing elective procedures under spinalanesthesia or peripheral nerve block with intravenous propofol sedation. Propofolsedation will be administered according to a standardized protocol and titrated to apredefined sedation depth using clinical sedation scales, with processedelectroencephalographic monitoring recorded when available. Standard intraoperativemonitoring will be performed according to institutional anesthetic practice.The study has two main comparisons. First, the two music groups will be pooled andcompared with the silence group to assess whether auditory stimulation increases dreamrecall. Second, the preferred music group will be compared with the matched non‐preferredmusic group to assess whether personalization improves dream pleasantness amongparticipants who recall dreams. Dream recall and dream pleasantness will be assessed inthe post‐anesthesia care unit using a standardized, neutral interview after participantsmeet predefined recovery‐readiness criteria.Additional assessments will include coded dream content, auditory salience, emotionalvalence, vividness, perceived control within the dream, patient satisfaction, propofoldose, opioid use, hemodynamic variability, recovery time, postoperative pain,postoperative nausea and vomiting, and adverse events. Dream narratives will be coded byblinded assessors using a prespecified codebook. Outcome assessors, content coders, andstatisticians will remain blinded to group allocation whenever feasible.The overall aim is to determine whether structured headphone‐based music, particularlypatient‐preferred music, can improve the subjective quality of propofol sedation whilemaintaining clinical safety. The findings may inform whether routine music delivery andoptional music preference capture should be incorporated into perioperative sedationworkflows.