{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:49:05Z","timestamp":1789055345937,"version":"build-2803163510"},"reference-count":98,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T00:00:00Z","timestamp":1629331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>General anesthesia should induce unconsciousness and provide amnesia. Amnesia refers to the absence of explicit and implicit memories. Unlike explicit memory, implicit memory is not consciously recalled, and it can affect behavior\/performance at a later time. The impact of general anesthesia in preventing implicit memory formation is not well-established. We performed a systematic review with meta-analysis of studies reporting implicit memory occurrence in adult patients after deep sedation (Observer\u2019s Assessment of Alertness\/Sedation of 0\u20131 with spontaneous breathing) or general anesthesia. We also evaluated the impact of different anesthetic\/analgesic regimens and the time point of auditory task delivery on implicit memory formation. The meta-analysis included the estimation of odds ratios (ORs) and 95% confidence intervals (CIs). We included a total of 61 studies with 3906 patients and 119 different cohorts. For 43 cohorts (36.1%), implicit memory events were reported. The American Society of Anesthesiologists (ASA) physical status III\u2013IV was associated with a higher likelihood of implicit memory formation (OR:3.48; 95%CI:1.18\u201310.25, p &lt; 0.05) than ASA physical status I\u2013II. Further, there was a lower likelihood of implicit memory formation for deep sedation cases, compared to general anesthesia (OR:0.10; 95%CI:0.01\u20130.76, p &lt; 0.05) and for patients receiving premedication with benzodiazepines compared to not premedicated patients before general anesthesia (OR:0.35; 95%CI:0.13\u20130.93, p = 0.05).<\/jats:p>","DOI":"10.3390\/life11080850","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T09:58:06Z","timestamp":1629367086000},"page":"850","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Implicit Memory and Anesthesia: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"11","author":[{"given":"Federico","family":"Linassi","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Ca\u2019 Foncello Treviso Regional Hospital, Piazzale Ospedale 1, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6746-557X","authenticated-orcid":false,"given":"David Peter","family":"Obert","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Muenchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4968-8611","authenticated-orcid":false,"given":"Eleonora","family":"Maran","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care, Ca\u2019 Foncello Treviso Regional Hospital, Piazzale Ospedale 1, 31100 Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5112-9256","authenticated-orcid":false,"given":"Paola","family":"Tellaroli","sequence":"additional","affiliation":[{"name":"Department of Developmental Psychology and Socialisation, University of Padova, Via Venezia 8, 35121 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Kreuzer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, School of Medicine, Technical University of Munich, Ismaninger Str. 22, 81675 Muenchen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert David","family":"Sanders","sequence":"additional","affiliation":[{"name":"Department of Anaesthetics, Royal Prince Alfred Hospital, Camperdown, NSW 2050, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5104-4124","authenticated-orcid":false,"given":"Michele","family":"Carron","sequence":"additional","affiliation":[{"name":"Department of Medicine, Anaesthesiology and Intensive Care, University of Padova, Via C. Battisti 267, 35121 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1097\/ALN.0b013e318249d0a7","article-title":"Unresponsiveness \u2260 unconsciousness","volume":"116","author":"Sanders","year":"2012","journal-title":"Anesthesiology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.bpa.2005.07.011","article-title":"Anaesthesia defined (gentlemen, this is no humbug)","volume":"20","author":"Eger","year":"2006","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_3","first-page":"244","article-title":"Validity and reliability of the Observer\u2019s Assessment of Alertness\/Sedation Scale: Study with intravenous midazolam","volume":"10","author":"Chernik","year":"1990","journal-title":"J. Clin. 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