Hypnosis Plus Local Anesthesia Might Work Well for Some Surgeries

Study found it safe as general anesthesia, but experts say more research needed

TUESDAY, June 14 (HealthDay News) -- Certain surgeries that typically require the use of general anesthesia could be safely performed with localized anesthesia in combination with hypnosis, Belgian researchers suggest.

The finding stems from a pair of very small case-control studies that explored the combo's potential during surgical procedures performed for breast cancer patients and thyroid patients, respectively.

The studies revealed that, relative to general anesthesia, the local anesthesia/hypnosis approach sped up the healing process, reduced the need for post-surgery opioid drugs and reduced hospitalization time.

"There is still a lot of debate around the exact mechanism that allows hypnosis to reduce pain perception," said study author and professor Fabienne Roelants in a European Anaesthesiology Congress news release, "but what is absolutely clear is that it does so."

She and her colleague noted that other researchers have used brain imaging scans such as functional MRIs during hypnosis to document a reduction in the perception of pain.

"Imagine you are driving your car," co-author Dr. Christine Watremez said in the same news release. "You suddenly realize how far you have driven, but for a long time your mind has been elsewhere. This is extremely common, and is nothing more, nor less, than a mild hypnotic trance, a modified state of consciousness, with a different perception of the world. The principle of hypnosis is to focus one's attention on one particular point."

"We believe that our studies have shown considerable benefits for the [local anesthetic]/hypnosis combination," Watremez added, "and that such benefits are not only for patients, but also for health-care systems. By using hypnosis combined with [local anesthetic] we can reduce the costs involved in longer hospital stays, remove the need for patients to use opioid drugs, and increase their overall comfort and satisfaction levels."

Watremez and Roelants are both from the department of anesthesiology at the Cliniques Universitaires St. Luc (UCL) in Brussels. They and their UCL colleagues presented the findings last weekend at a meeting of the European Anaesthesiology Congress, in Amsterdam. Research presented at medical meetings should be viewed as preliminary until it is published in a peer-reviewed medical journal.

The authors stated that the potential overall effectiveness of hypnosis is not affected by either gender or age. Rather, patient motivation, trust and willingness to undergo the hypnotic process is key to its success.

In the breast cancer study, 18 women (out of 78 patients) underwent hypnosis and local anesthetic for a range of surgeries (partial mastectomy, sentinel node biopsy, or opening the armpit to remove lymph nodes); the other 58 underwent general anesthesia for the same operations. The thyroid study also involved 18 hypnosis/local anesthetic patients who underwent all or part of the thyroid gland, comparing them with 36 patients who underwent general anesthesia for the same surgery.

In both cases, the combo patients fared better in terms of recovery time, hospital stay and opiate drug use.

"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," explained Roelants.

Watremex added that "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."

Currently a third of all thyroid and breast cancer surgeries performed at UCL rely on the local anesthetic/hypnosis combo. The researchers suggest that the technique may also be applicable to a wide range of additional procedures, including carotid artery surgery, knee arthroscopy, gynecological surgery, plastic surgery and egg retrieval for fertility treatment.

But, Dr. Daniel Sessler, professor and chair of the department of outcomes research at The Cleveland Clinic in Ohio, cautioned that the current findings should not be viewed as conclusive.

"This is not a formal comparison of two anesthesiology options," he noted. "So, while on the one hand this legitimately shows that [the researchers] were able to use this hypnosis technique among particular patients -- and that for them it worked -- this is not a formal evaluation of hypnosis."

"So if the question is, 'Could hypnosis be useful in some select cases?', the answer is yes," Sesser said. "And to the extent that it does work for some patients, it is probably helpful and in the patient's best interest. But that is very different from saying that this is proof that hypnosis always works for all patients. We cannot say that at all from this [study]."

More information

For more on hypnosis, visit the National Center for Complementary and Alternative Medicine.

Alan Mozes SOURCES: Daniel Sessler, M.D., professor and chair, department of outcomes research, The Cleveland Clinic, Ohio; European Anaesthesiology Congress, June 12, 2011, news release

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