Learning during anesthesia: myth or reality?

Learning occurs in both explicit and implicit manners. The core purpose of all learning, whether implicit or explicit, is the changing of ideas, behaviors, and/or values. Of major concern to perianesthesia nurses is the safety and comfort of the anesthetized patient. Many patients express the concern that they will hear or, worse still, feel part of their surgery while it is being performed. Patients have learned, explicitly and anecdotally, that such things may occur. This fear is not unfounded, as there have been many reports written describing the phenomenon of intraoperative recall, as well as its prevention and treatment. The concept of implicit learning during anesthesia, however, is much less well known. The primary foci of this article are to evaluate the veracity of the existence of implicit learning, review the techniques by which it is measured, and examine behaviors and/or techniques which enhance (strengthen stimuli) or retard it (suppress stimuli).