ESA: Hypnosis + local anesthesia prove beneficial in surgeries
Hypnosis used in combination with local anesthesia (LA) may improve healing time, reduce drug use and lengths of stay for patients undergoing certain types of surgery, according to two studies presented June 12 at the European Anesthesiology Conference in Amsterdam, which assessed hypnosis and LA compared with using general anesthesia (GA) for patients undergoing thyroidectomies and breast cancer surgeries.
“In addition to reducing drug use and hospital stay time, being able to avoid general anesthesia in breast cancer surgery is important because we know that local anesthesia can block the body’s stress response to surgery and could therefore reduce the possible spread of metastases,” said Fabienne Roelants, MD, department of anesthesiology at the Cliniques Universitaires Saint-Luc in Brussels, Belgium.
In one study, 18 patients undergoing video-assisted thyroidectomies (VAT) were hypnotized using an eye fixation procedure and progressive muscle relaxation in combination with LA performed by a surgeon using lidocaine and levobupivacaine. In the GA group, 36 patients were induced with propofol and remifentanil. Operative time, time spent in the operating room, preoperative ephedrine consumption, pain scores, nausea, opioid consumption in the recovery room as well as patient satisfaction and the potential discharge at six hour were noted.
Researchers concluded that hypnosis and LA combined with VAT can be safely performed to obtain a less invasive technique for thyroidectomy. Hypnosis presented fewer side effects than GA and could potentially decrease the cost of the procedure and shorten the hospital stay.
In a study of patients undergoing breast cancer surgery, hypnosis used in combination with LA proved beneficial as well. Researchers retrospectively compared a series of breast cancer surgery patients who were operated on while under hypnosis with those operated on while under general anesthesia. There were 18 women induced using hypnosis and LA and 60 women induce with GA. Researchers found that hypnosis and LA can be safely used for breast cancer surgery, reducing opioid use and hospital stay.
Christine Watremez, MD, department of anesthesiology at the Cliniques Universitaires Saint-Luc in Brussels, Belgium, noted special precautions necessary for hypnosis.
“Together with our anesthesiologists at the hospital, we are specialized in hypnosis,” she said. “Although there are special precautions to be taken—for example, only the hypnotherapist should talk to the patient during the procedure and should avoid negatives, which unconsciousness cannot handle, and the surgeon needs to be gentle, avoid any tugging in his movements, and be able to remain cool in all circumstances—it is a straightforward procedure and appreciated by the patients.”
Researchers noted that hypnosis can be used in other operations besides thyroidectomies and breast cancer surgery, such as carotid artery surgery, inguinal kernia and knee anthroscopy, among others.
“We believe that our studies have shown considerable benefits for the LA/hypnosis combination, and that such benefits are not only for patients, but also for healthcare systems. By using hypnosis combined with LA we can reduce costs involved in larger hospital stays, remove the need for patients to use opioid drugs, and increase their overall comfort and satisfaction levels,” said Watremez. “To date there are few publications about the use of hypnosis in surgery, and we hope that, by contributing to the body of evidence on its efficacy, our research will encourage others to carry out this procedure to the advantage of all concerned.”
“In addition to reducing drug use and hospital stay time, being able to avoid general anesthesia in breast cancer surgery is important because we know that local anesthesia can block the body’s stress response to surgery and could therefore reduce the possible spread of metastases,” said Fabienne Roelants, MD, department of anesthesiology at the Cliniques Universitaires Saint-Luc in Brussels, Belgium.
In one study, 18 patients undergoing video-assisted thyroidectomies (VAT) were hypnotized using an eye fixation procedure and progressive muscle relaxation in combination with LA performed by a surgeon using lidocaine and levobupivacaine. In the GA group, 36 patients were induced with propofol and remifentanil. Operative time, time spent in the operating room, preoperative ephedrine consumption, pain scores, nausea, opioid consumption in the recovery room as well as patient satisfaction and the potential discharge at six hour were noted.
Researchers concluded that hypnosis and LA combined with VAT can be safely performed to obtain a less invasive technique for thyroidectomy. Hypnosis presented fewer side effects than GA and could potentially decrease the cost of the procedure and shorten the hospital stay.
In a study of patients undergoing breast cancer surgery, hypnosis used in combination with LA proved beneficial as well. Researchers retrospectively compared a series of breast cancer surgery patients who were operated on while under hypnosis with those operated on while under general anesthesia. There were 18 women induced using hypnosis and LA and 60 women induce with GA. Researchers found that hypnosis and LA can be safely used for breast cancer surgery, reducing opioid use and hospital stay.
Christine Watremez, MD, department of anesthesiology at the Cliniques Universitaires Saint-Luc in Brussels, Belgium, noted special precautions necessary for hypnosis.
“Together with our anesthesiologists at the hospital, we are specialized in hypnosis,” she said. “Although there are special precautions to be taken—for example, only the hypnotherapist should talk to the patient during the procedure and should avoid negatives, which unconsciousness cannot handle, and the surgeon needs to be gentle, avoid any tugging in his movements, and be able to remain cool in all circumstances—it is a straightforward procedure and appreciated by the patients.”
Researchers noted that hypnosis can be used in other operations besides thyroidectomies and breast cancer surgery, such as carotid artery surgery, inguinal kernia and knee anthroscopy, among others.
“We believe that our studies have shown considerable benefits for the LA/hypnosis combination, and that such benefits are not only for patients, but also for healthcare systems. By using hypnosis combined with LA we can reduce costs involved in larger hospital stays, remove the need for patients to use opioid drugs, and increase their overall comfort and satisfaction levels,” said Watremez. “To date there are few publications about the use of hypnosis in surgery, and we hope that, by contributing to the body of evidence on its efficacy, our research will encourage others to carry out this procedure to the advantage of all concerned.”