Influence of some anesthetics and sedatives on source of sexual hallucination: undervalued forensic risk for doctors

Czech version

Authors: Jana Kučerová ¹; Petr Kovář ²; Tomáš Adamus ³
Authors‘ workplace: Gynprenatal s. r. o., Havířov, vedoucí lékař MUDr. Petr Kovář ¹; Katedra chirurgických oborů (gynekologie), LF OU v Ostravě, vedoucí katedry doc. MUDr. Jan Dostalík, CSc. ^1,2; Katedra biomedicínských oborů, LF OU, Ostrava, vedoucí katedry doc. RNDr. Kristian Šafarčík, Ph. D. ³
Published in: Prakt Gyn 2013; 17(1): 74-78
Category: Gynecology and Obstetrics: Review Article

Overview

Introduction:
One of the worst allegations for a doctor is accusation of sexual molestation. Hallucination with sexual content can appear when using some common anesthetics and sedatives, they are mostly very vivid and it is very difficult to distinguish them from reality. For judicial proceeding it is afterwards very complicated to recognize, if a real criminal act was committed or it is only a false accusation.

Aim:
We are pointing at some risks in the cause of sexual hallucinations and dreams under anesthesia and sedation and suggesting some arrangement against accusations.

Methods:
We are drawing on still published literature on this problem.

Conclusion:
Cases of sexual assault are for the media attractive and they can bring serious consequences for the job, career and family. Despite a proof of innocence, the reputation of the doctor and the medical stuff may suffer. That is why it is important to realize this problem and make steps to reduce any possible risks.

Key words:
anesthetics – forensic proceeding – protective arrangements – sedatives – sexual hallucination

Sources

1. Balasubramaniam B, Park GR. Sexual hallucinations during and after sedation and anaesthesia. Anaesthesia 2003; 58(6): 549–553.

2. Schneemilch C, Schilz K, Meinshausen E, Hachenberg T. [Sexual hallucinations and dreams under anesthesia and sedation: medicolegal aspects; originál německy]. Anaesthesist 2012; 61(3): 234–241.

3. Rose D. Sexual hallucination a growing problem. 2009. Dostupné z WWW: <http://news.smh.com.au/action/printArticle?id=975969>.

4. Davy H. Researches, Chemical and Philosophical Chiefly Concerning Nitrous Oxide. (Facsimile of 1800 edition) Butterworths: London 1977.

5. Stoelting RK, Miller RD. Basics for Anaesthesia. 5th Ed. Churchill Livingstone-Evolve: Philadephia (PA) 2006.

6. Simpson JY. Chloroform in maternity. Lancet 1849; 1: 235–236.

7. Simpson JY. On a new Anaesthetic Agent, more efficient than sulphuric ether. Lancet 1847; 2: 549–550.

8. Atkinson RS. James Simpson and Chloroform. Priory Press: London 1973; 76–77.

9. Snow J. The alleged employment of chloroform by thieves. London Medical Gazette 1850; 41: 327.

10. Snow J. Further remarks on the employment of chloroform by thieves. London Medical Gazette 1850; 45: 834–835.

11. Ramsay MAE. John Snow, MD: anaesthetist to the Queen of England and pioneer epidemiologist. Proc (Bayl Univ Med Cent) 2006; 19(1): 24–28.

12. Smith WT. A lecture on utility and safety of the inhalation of ether in obstetric practice. Lancet 1848; 1: 375–378.

13. Gream GT. Chloroform in midwifery. Lancet 1849; 1: 99–100.

14. Stille M. The psychical effects of ether inhalation. Med Examiner 1854; 10: 730–739.

15. Drábková J. Návykové látky. Referátový výběr z anesteziologie, resuscitace a intenzivní medicíny (Suplementum 6/2004).

16. Raboch J, Pavlovský P, Janotová D. Psychiatrie minimum pro praxi. 4.ed. Triton: Praha 2006. ISBN 80–7254–746–1.

17. Strickland R, Butterworth JF. Sexual dreaming during anaestesia. Anestesiology 2007; 106(6): 1232–1236.

18. Suresh D. Nigthmares and recovery from anestesia. Anesth Analg 1991; 72(3): 404–405.

19. Toscano A, Pancaro C, Peduto VA. Scopolamine prevents dreams during general anaestesia. Anestesiology 2007; 106(5): 952–955.

20. Wawersik J. History of chloroform anaesthesia. Allerg Immunol 1998; 30(5): 135–137.

21. Larsen R et al. Anestezie. [Anästhesie. 7. Aufl. Urban & Fischer Verlag 2002] 2. ed. (překlad). Grada Publishing: Praha 2004. ISBN 80–247–0476–5.

22. Kovář P. Vliv běžných léků a některých drog na sexuální chování a jednání. In: Kovář P (ed) et al. Sexuální agrese. Maxdorf: Praha 2008. ISBN 978–80–7345–161–5.

23. Dundee JW. Fantasies during sedation with intravenous midazolam or diazepam. Med Leg J 1990; 58 (Pt 1): 29–34.

24. Brahams D, Benzodiazepines and sexual fantasies. Lancet 1990; 335(8682): 157.

25. Litchfield NB. Complication of intravenous diazepam – adverse psychological reactions. Anesth Prog 1980; 28(6): 175–183.

26. Minichetti J, Miles M. Hallucination and delirium reaction to intravenous diazepam administrativ: Case report. Anesth Prog 1982; 29(5): 144–146.

27. Young PN. Hallucinations after propofol. Anaesthesia 1988; 43(2): 170.

28. Thomson KD, Knight A B. Hallucinations after propofol. Anaesthesia 1988; 43(2): 171–172.

29. Canaday BR. Amorous, disinhibited behavior associated with propofol. Clin Pharm 1993; 12(2): 449–451.

30. SÚKL. Souhrn údajů o přípravku. Propofol-Lipuro 2%. 2011. Dostupné z WWW: <http://www.sukl.cz/modules/medication/search.php?data%5Bsearch_for%5D=Propofol-Lipuro>.

31. Hynie S. Látky ovlivňující CNS. In: Hynie S. Specialní farmakologie. 2. přepr. vyd. Karolinum: Praha 2000. Díl 3. ISBN 80–246–0122–2.