Some Studies on Hypnosis and Surgery

New York Times

Using Hypnosis to Gain More Control Over Your Illness

By LESLEY ALDERMAN, published April 15, 2011 KIRSTEN RITCHIE, 44, is no stranger to surgery — nearly 20 years ago, doctors removed four tumors from her brain. She remembers the operation and its aftermath as “horrific.” So the news that she needed brain surgery again was hardly welcome. Determined to make her second operation a better — or at least less traumatic — experience, Ms. Ritchie, an insurance marketing representative in Cleveland, turned to an unusual treatment.

At the Cleveland Clinic’s Center for Integrative Medicine, she had four hypnosis sessions in the month before her procedure, during which she addressed her fear of the coming surgery. She also practiced self-hypnosis every day.

Eventually, she said, “I got to a place where I felt a sense of trust instead of fear.”

In February, doctors removed a plum-sized tumor from her brain. But there the similarity to her previous experience ended. Ms. Ritchie woke up from the procedure, she said, feeling “alert and awesome.” She ate a full dinner that night and went home in two days.

“My neurosurgeon was stunned at how little medication I required before and after surgery, and how quickly I bounced back,” she said.

Ms. Ritchie attributes her speedy recovery and calm state to her hypnosis sessions. Used for more than two centuries to treat a host of medical problems, particularly pain management and anxiety, hypnosis is now available to patients at some of the most respected medical institutions in the country, including Stanford Hospital, the Cleveland Clinic, Mount Sinai Medical Center and Beth Israel Medical Center in New York.

Some critics find the research into mind-body therapies unconvincing, but their skepticism has not deterred patients like Ms. Ritchie. And there are researchers who say they believe that by helping patients feel in better control of their symptoms, hypnosis can reduce the need for medication and lower costs.

“It is an effective and inexpensive way to manage medical care,” said Dr. David Spiegel, director of the Center on Stress and Health at Stanford University School of Medicine and a leading authority on hypnosis.

A study by radiologists at Harvard Medical School, published in 2000, found that patients who received hypnosis during surgery required less medication, had fewer complications and shorter procedures than patients who did not have hypnosis. In a follow-up study in 2002, the radiologists concluded that if every patient undergoing catheterization were to receive hypnosis, the cost savings would amount to $338 per patient.

“When patients are groggy from anesthesia drugs, it costs more to recover them,” said Dr. Elvira Lang, an associate professor of radiology at Harvard Medical School and a lead author of both studies. “Hypnosis calms patients.”

If you have a medical condition for which conventional medicine is not working, or you’d like to try a gentle mind-body alternative, hypnosis may be worth considering......

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Western Journal of Medicine

Verbal instructions before major operations can influence recovery and cut hospital stays.

During abdominal surgery, the stomach and intestines usually go on strike. Gut movement and digestion are halted. Nothing can be eaten or drunk for days. Anybody who had undergone this ordeal will know that all-important signal that the gut is working again: passing gas. This means the food can be consumed and going home is probably not far away.

A recent study indicates that giving patients specific verbal suggestions before major operations can influence physiological recovery.

In a study of 40 patients undergoing abdominal surgery, one group was given a 5-minute presentation of general instructions and reassurance while patients in the experimental group received 5 minutes of specific instructions about restoring bowl function.

As predicted, patients receiving specific suggestions reported passing first gas after only 2.6 days compared to 4.2 days for the control group of patients. Length of time until first meal, another measure of return of bowl function, also favored the preoperative suggestion group. Though not statistically significant, the experimental group also was discharged from their hospital in 6.5 days on average - 1.5 days earlier than the control group of patients.If these trend results are found significant with a larger group of patients, the projected savings from these brief verbal instructions would be $1,200 per patient assuming minimum room rate of $800.00 per day.

For more information: Disbow EA, Bennett HL, Owings JT: Effect of preoperative suggestion on postoperative gastrointestinal motility. Western Journal of Medicine 1993; 158:488-492

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From the Journal of American Family Physician

Relaxation technique reduces patient anxiety before surgery

(85th Scientific Assembly and Annual Meeting of the Radiological Society of North America)

The use of hypnotic relaxation techniques before some medical procedures reduced patients' anxiety and pain during the procedures, decreased procedure time and cost, and, in nearly one half of the cases, eliminated the need for conscious sedation altogether.

These were the finding of a study of 161 patients undergoing angiography, angioplasty or kidney drainage. The relaxation technique involved a specially trained nurse or team member reading a script telling the patient to close and relax their eyes, take deep breaths, feel a sensation of floating and to a safe and comfortable place.

The patients were given a bell to ring at any point during the procedure if they felt the need for more anesthesia. All of the patients were offered conscious sedation (a mixture of anti-pain and anti-anxiety medication). Fourteen of the 79 patients (18%) who did not undergo relaxation techniques requested no sedation, compared with 38 of the 82 patients (46%) who underwent relaxation techniques. Replacing or supplementing anesthesia with the relaxation techniques reduced the average procedure time by 17 minutes (20% of total procedure time) and reduced the average procedure cost by $130.00 per patient. This reduction in cost was primarily the result of fewer interruptions during the procedures, and avoiding over or under sedation that usually results in the patient being admitted to the hospital overnight instead of being released within a few hours of the procedure.

Elvira V. Lang, M.D. Harvard Medical School, Boston, Massachusetts

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ABC News

Hypnosis reduces breast surgery side effects: pain, nausea and other side effects mitigated by pre-surgery sessions, study shows

By Susan Kansagra, M.D.,ABC News Medical Unit Aug. 28, 2007

It's something that's usually associated with stage performances and helping smokers quit, but new research suggests hypnosis may soon be an important tool in helping patients endure common side effects of breast cancer surgery.

Researchers at the Mount Sinai School of Medicine in New York showed that a 15-minute hypnosis session reduced side effects including pain, nausea and emotional distress in patients undergoing breast cancer operations. The study was published Tuesday in the Journal of the National Cancer Institute. "If this were a drug, it would be very successful," said lead study author Guy Montgomery, director of the Integrative Behavioral Medicine Program at Mount Sinai School of Medicine. Montgomery added that hypnosis carries the added benefit of having no side effects - a quality that makes it an attractive alternative to many drugs used for similar purposes.

Two hundred women who were about to undergo surgeries like a breast biopsy or removal of a suspicious breast lump participated in the study. About half of the women received a 15-minute hypnosis session shortly before their operations. The other women in the study had a consultation with a psychologist before the surgery. The hypnosis session included relaxation exercises that encouraged the women to think of pleasant thoughts, such as a beach on a warm day. The women who did not undergo hypnosis talked to a psychologist, who listened and offered supportive comments. After their surgeries, the women who had hypnosis experienced less pain, nausea, fatigue, discomfort and emotional upset than their counterparts - - and these differences were substantial, the study's author reported.

Not only did hypnosis reduce the side effects from surgery, but it also did this while reducing the amount of anesthesia used during the surgery. Additionally, the researchers showed that hypnosis decreased the amount of time spent in the operating room by almost 11 minutes, leading to an overall cost savings of about $770.00 per patient. These results were seen despite the fact that treatments involving hypnotism don't work for everyone; previous studies have shown that about 11% of people are resistant to hypnosis. But researchers noted that the tests used to weed out hypnosis-resistant women from the study would have taken longer to perform than the hypnosis itself. …

It also helps take attention away from pain, and some studies have even shown that hypnosis can actually change the way a patient perceives pain. "When we take an aspirin, we expect to have headache relief," Montgomery said. "One of the things hypnosis is very good at is helping people form expectancy to these outcomes, such as less pain and less nausea."… C. Richard Chapman, professor and director of the Pain Research Center at the University of Utah said, "This study adds to a growing body of evidence showing that psychological interventions complement medical interventions. Such interventions empower patients by engaging them in their own care and giving them control over their own pain, nausea and discomfort." Montgomery said that even patients who are skeptical about or fearful of hypnosis can take advantage of its benefits if they are properly counseled. “We're going to tell you that hypnosis is typically not like hypnosis used in television or seen in movies," he said. "Rather, its something that we can do together that can help you reduce side effects. You're really the person in control." Adding to this notion is the fact that the hypnosis sessions the women underwent included instruction on how they could perform hypnosis on themselves in the future.

Not Just for Breast Cancer Surgery

In addition to being effective, hypnosis may also prove to be a versatile tool. The benefits of hypnosis have been shown in previous research to extend to other procedures as well, including gynecological surgery and coronary artery bypass. Montgomery said he is hopeful that doctors continue to expand the use of hypnosis in other medical applications. "This could become part of standard care," he said. However, he added, "it's not a panacea for everything, but rather a tool in the toolbox that we can use to address specific problems."

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