Memory During Anesthesia: the Role of Stress Hormones

Study Overview
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Brief Summary
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To investigate whether the auditory stimulation causes changes in hormones levels (cortisol+prolactin) during general anesthesia. To determine if there is a correlation between hormones levels (cortisol+prolactin) and dreams recall. To investigate whether, in patients receiving auditory stimulation, there is a correlation between hormones levels (cortisol+prolactin), serum remifentanil concentration and detection of implicit memory. To investigate the presence of primary auditory cortex activation (temporal lobe) in patients with implicit memory and in those with dreams recall using the EEG-ERP 128 channels GES300 EGI system.

Detailed Description
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Patients from group A, during maintenance of anesthesia, at the time of trocar insertion, will listen (via MP3) a piece of one of two stories, Puss in Boots and Pinocchio, each followed by four keywords. In group B, patients will be isolated from the sounds of the operating room using specific headphones.

Conditions
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Surgical Procedure, Unspecified

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age between 18 and 70 years old Class-ASA Physical Status I-II Exclusion Criteria: Psychiatric or neurological disorders and/or hearing disorders Obesity (Body Mass Index > 30) Drug addiction, alcoholism Patients with an education level below middle school Patients with difficulty in understanding the Italian language Patients treated with corticosteroids and/or estrogens, pregnant patients and patients suffering from hypercorticism

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Hormones levels | The blood sample will be taken during anaesthesia to determine intraoperative hormones (cortisol + prolactine) levels. | 5 minutes after achieving a pneumoperitoneum pressure of 12 mmHg | 
| Hormones levels | The blood sample will be taken 30 minutes before induction of anaesthesia to determine baseline hormones (cortisol + prolactine) levels. | Baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Remifentanil concentration | One blood sample will be taken to determine steady state concentration of remifentanil (only in a subset of patients). | 5 minutes after achieving a pneumoperitoneum pressure of 12 mmHg | 
| Memory | Patients will be asked to associate with keywords the first thing that comes them to mind (implicit memory). Also eplicit memory and dreams recall will be tested at the same time. The content of intraoperative dreams (confirmed by a brief post-anesthesia interview) will be analyzed using the 5-point Likert scale. | Approximately 24 hours after surgery for explicit memory, implicit memory and for dreams recall detected after awakening from anesthesia | 
| Primary auditory cortex activation | ERP-EEG monitoring system with 128 channel EGI GES300 | 5 minutes after achieving a pneumoperitoneum pressure of 12 mmHg | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Laparoscopic