Surgery

by | Surgery

The Journal of the National Cancer Institute paper is just the latest to conclude that hypnosis can help with operations. Dr. Guy Montgomery led a research study of 200 women with 15-minute hypnosis or conversation with psychologist prior to surgery. Hypnosis needed less anesthetic than the others, less pain, nausea, fatigue and emotional distress after operation.

Dr. David Spiegel, Stanford University School of Medicine, wrote; "You have to pay attention to pain for it to hurt, and it is entirely possible to substantially alter pain perception during surgical procedures by inducing hypnotic relaxation, transforming perception in part or directing attention elsewhere."

Hypnosis has been demonstrated to reduce analogue pain, and studies on the mechanisms of laboratory pain reduction have provided useful applications to clinical populations. Studies showing central nervous system activity during hypnotic procedures offer preliminary information concerning possible physiological mechanisms of hypnotic analgesia. Randomized controlled studies with clinical populations indicate that hypnosis has a reliable and significant impact on acute procedural pain and chronic pain conditions. Methodological issues of this body of research are discussed, as are methods to better integrate hypnosis into comprehensive pain treatment. Hypnosis and Clinical pain. Patterson DR, Jensen MP, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA USA 98104 Psychol Bull. 2003 Jul;129(4):495-521.

Study of hypnosis in more than 1400 patients undergoing surgery. Use of hypnosis was associated with improved intraoperative patient comfort, and with reduced anxiety, pain, intraoperative requirements for anxiolytic and analgesic drugs, optimal surgical conditions and a faster recovery of the patient. Hypnosis and its application in surgery. Faymonville ME, Defechereux T, Joris J,et al. Service d’Anesthesie-Reanimation, Universite de Liege, Rev Med Liege. 1998 Jul;53(7):414-8.

Montgomery, David, Winkel, Silverstein & Bovbjerg (2002).This meta-analysis examined the results of 20 published controlled studies examining the use of hypnosis as an adjunct with surgical patients. In these studies hypnosis was typically administered to patients in the form of a relaxing induction phase followed by suggestions for the control of side effect profiles (e.g. pain, nausea, distress). Only studies in which patients were randomized to either a hypnosis or control group (no-treatment, routine care, or attention control group) were included. The results revealed that patients in the hypnosis treatment groups had better outcomes than 89% of the patients in the control groups. It was found that adjunctive hypnosis helped the majority of patients reduce adverse consequences of surgical interventions.

Famonville, Mambourg, Joris, et al (1997), randomly allocated 60 patients undergoing plastic surgery with conscious sedation to either a control group with stress reducing strategies or a hypnosis group. Intraoperative and postoperative anxiety and pain were significantly lower in hypnosis group, along with a significant reduction in the amount of drug required for conscious sedation.

Montgomery, Weltz, Seitz and Bovbjerg (2002) conducted a trial with 20 women randomized to standard care versus pre-operative hypnosis for excisional breast biopsy. In their study they found brief (10-minute) hypnosis to be effective in reducing postsurgery pain.

Tusek D, Church JM, Fazio VW. Guided imagery as a coping strategy for preoperative patients. AORN J. 1997 Oct; 66(4):644-0. The authors randomly assigned 130 patients into two groups. Those who listened to guided imagery tapes for three days before their surgical procedures, during and six days after surgery experienced considerably less pre and postoperative anxiety and pain and required almost 50% less narcotic medications after their surgical procedures than patients in the control group.

Other studies in surgery

  • Bennett HL. A comparison of audiotaped preparations for surgery: evaluation and outcomes. Paper presented at the annual meeting of the Society for Clinical and Experimental Hypnosis, 1996. Tampa, FL.
  • Bennett HL, Benson DR, Kuiken, DA. Preoperative instructions for decreased bleeding during spine surgery. Anesthesiology. 1986 65:A245.
  • Blankenfield, RP (1991). Suggestion, relaxation and hypnosis as adjuncts in the care of surgery patients: A review of the literature. American Journal of Clinical Hypnosis 33, 172-186.
  • Daake DA, Gueldner SH. Imagery, instruction and the control of post surgical pain. Applied Nursing Research. 1989 2 114-120.
  • Disbrow EA, Bennett HL, Owings JT. Effect of preoperative suggestion on postoperative gastrointestinal modality. West J Med. 1993 May;158(5);488-92.
  • Dreher H. Mind-body interventions for surgery: evidence and exigency. Advances in Mind-Body Medicine. 1998. 14:207-222.
  • Elkins, G. Jensen, MP, Patterson DR. Hypnotherapy for the management of chronic pain. Intl J of Clin and Exper Hypnosis 2007; 55:275-87.
  • Faymonville ME, Fissette J, Mambourg PH, Roediger L, Joris J, Lamy M. Hypnosis as adjunct therapy in conscious sedation for plastic surgery. Reg. Anesth. 1995 Mar-Apr;20(2):145-51.
  • Fontana GP. Acupuncture, Massage, Guided Imagery Ease Pain After Bypass Surgery. News release, Westport, Conn: Reuters Health Information, June 9. 2000 p1-2.
  • Ginandes C. Brooks P, Sando W, Jones C, Aker J. Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. Am J Clin Hypn. 2003 Apr;45(4):333-51.
  • Holden-Lund C. Effects of relaxation with guided imagery on surgical stress and wound healing. Research in Nursing and Health. 1988 11 Aug. 235-244.
  • Kshettry VR, Carole LF, Henly SJ, Sendelbach S, Kummer B. Complementary alternative medical therapies for heart surgery patients: feasibility, safety, and impact. Ann Thorac Surg. 2006 Jan;81(1):201-5.
  • Laurion S, Fetzer SJ. The effect of two nursing interventions on the postoperative outcomes of gynecological laparoscopic patients. J of Perianesthesia Nursing. 2003 Aug;18(4)254-61.
  • Manyande A, Berg S, Gettins D, et al. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosom Med. 1995; 59(2): 177-182.
  • Rapkin DA, Straubing M, Holroyd JC. Guided imagery, hypnosis and recovery from head and neck cancer surgery: an exploratory study. Int J Clin Exp Hypn. 1991 Oct;39(4) :215-26.
  • Schwab D., Davies, et al. A study of efficacy and cost-effectiveness of guided imagery as portable, self-administered, presurgical intervention delivered by a health plan. Advances in Mind-Body Medicine. 2007, Summer 22(1).
  • Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW. Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery. Dis Colon Rectum. 1997 Feb;40(2):172-8.
  • Tusek DL, Cwynar R, Cosgrove DM. Effect of guided imagery on length of stay, pain and anxiety in cardiac surgery patients. J Cardiovasc Manag. 1999 Mar-Apr;10(2) :22-8.
  • Tusek DL., Guided imagery: a powerful tool to decrease length of stay, pain, anxiety and narcotic consumption. J Invasive Cardiol. 1999 Apr; 11(4):265-7.