Hypnosis and Surgery: Past, Present, and Future

Abstract

Hypnosis has been defined as the induction of a subjective state in which alterations of perception or memory can be elicited by suggestion. Ever since the first public demonstrations of "animal magnetism" by Mesmer in the 18th century, the use of this psychological tool has fascinated the medical community and public alike. The application of hypnosis to alter pain perception and memory dates back centuries. Yet little progress has been made to fully comprehend or appreciate its potential compared to the pharmacologic advances in anesthesiology. Recently, hypnosis has aroused interest, as hypnosis seems to complement and possibly enhance conscious sedation. Contemporary clinical investigators claim that the combination of analgesia and hypnosis is superior to conventional pharmacologic anesthesia for minor surgical cases, with patients and surgeons responding favorably. Simultaneously, basic research of pain pathways involving the nociceptive flexion reflex and positron emission tomography has yielded objective data regarding the physiologic correlates of hypnosis. In this article I review the history, basic scientific and clinical studies, and modern practical considerations of one of the oldest therapeutical tools: the power of suggestion.

Use of hypnosis as a substitute premedication and adjunct to anesthesia

“…In our study, only 2 patients required pharmacological therapy for PONV. Previous studies have shown that hypnosis is effective for prevention of nausea and vomiting [1,2,18,19]. All 15 patients in our study also had smooth postoperative course and reported complete amnesia for intra-operative events.…”

“…Although hypnotism is known to have been practiced by many people, it was James Braid who popularised its use in anesthesia. With the advent and rapid popularity of nitrous oxide, ether and chloroform, and also thanks to the discredit from the use of hypnosis by stage hypnotists and charlatans, the use of hypnosis in anesthesia dwindled [2]. The regained interest and use of hypnosis in anesthesia practice can be largely attributed to the recognition by British Medical Association (1995) and American Medical Association (1958).…”

Effects of patient education and therapeutic suggestions on cataract surgery patients: A randomized controlled clinical trial

“…Although suggestions are one of the most important tools of hypnosis, suggestive techniques can be successfully used without formal hypnosis induction as well [20]. Studies support that suggestions have beneficial impact on various surgical outcomes [22,23], and specifically on mitigating procedural anxiety (e.g. [24][25][26]).…”

Negative und positive Suggestionen in der Anästhesie

“…> Im Trancezustand kann ein posthypnotischer Auftrag gegeben werden [19]. Wie effektiv solche positiven Suggestio nen wirken, zeigt auch die Anwendung von Hypnose in der Zahnmedizin [50] und Medizin [52], speziell bei operativen Eingriffen [2,28,44,67], belastenden Un tersuchungen wie Endoskopien [3,30], bei Venenpunktion [38] und in der Schmerz therapie [44,46]. So wurde z.…”

“…Zahlreiche Studien haben güns tige Effekte bei Patienten unter Allgemein anästhesie nachgewiesen, denen intra operativ Suggestionen direkt oder über Band zugesprochen wurden. Es wurden eine verringerte Inzidenz von PONV, Fie ber und Kopfschmerz, eine größere hä modynamische Stabilität, ein geringe rer postoperativer Analgetikabedarf, eine frühere Mobilisation und eine verkürz te Krankenhausliegedauer nachgewiesen [13,18,44,45,67]. Aus diesen klinischen Untersuchungen und der Hypnosefor schung sind vielfältige Wirkungen von positiven Suggestionen auf unterschied liche Parameter und Symptome bekannt (.…”