Hypnosis as sole anesthesia for major surgeries: historical & contemporary perspectives

Clinical hypnosis: implications in anaesthesia and perioperative care

A randomised trial published in the British Journal of Anaesthesia describes hypnosis compared with general anaesthesia in 60 children undergoing superficial surgery. We describe a definition of clinical hypnosis; the goals and conduct of hypnotic communication; and its potential as both an adjunct and, in suitable cases, alternative to traditional pharmacological anaesthesia.

Effectiveness of a Brief Hypnotic Induction in Third Molar Extraction: A Randomized Controlled Trial (HypMol)

Third molar extraction is a painful treatment for patients, and thus, it can be used to investigate the effects of analgesics on pain. Hypnosis can help to reduce pain and to decrease the intake of postoperative systemic analgesics. In this study, the effectiveness of a brief hypnotic induction for patients undergoing third molar extractions was investigated. Data were collected from 33 patients with third molar extractions on the right and left sides. Patients received 2 different types of pain interventions in this monocentric randomized crossover trial. Third molar extraction was conducted on 1 side with reduced preoperative local anesthetics and an additional brief hypnotic induction (Dave Elman technique). The other side was conducted with regular preoperative local anesthetics without a brief hypnotic induction (standard care). Intake of postoperative systemic analgesics was allowed in both treatments. Patients' expectations about hypnosis were assessed at baseline. The primary outcome was the area under the curve with respect to ground of pain intensity after the treatment. Secondary outcomes were the amount of postoperative analgesics consumed and the preferred treatment. There was no evidence that the area under the curve with respect to ground of pain differed between the 2 interventions (controlling for gender), but the patients' expectations affected the effectiveness of the brief hypnotic induction. This means that patients with high expectations about hypnosis benefit more from treatment with reduced preoperative local anesthetics and additional brief hypnotic induction. PERSPECTIVE: Hypnosis is used as a treatment to reduce pain in general and dental settings. In this study, additional a brief hypnotic induction with reduced preoperative local anesthetic use did not generally reduce posttreatment pain after third molar extraction more than regular local anesthetics. The expectation of the patients about the effectiveness of hypnosis affected the effectiveness of the brief hypnotic induction so that patients with high expectations had a larger benefit from a brief hypnotic induction than patients with low expectations.

Hypnosis as sole anesthesia for oral surgery: The egg of Columbus

BACKGROUND AND OVERVIEW

Hypnosis, despite its effectiveness, has been neglected. The aim of this study is to show the effectiveness and manageability of hypnosis as a stand-alone technique in dentistry.

CASE DESCRIPTION

Three patients underwent 6 oral surgery procedures (surgical third-molar removal, implant surgery, maxillary bone augmentation, and mucogingival surgery) with hypnosis as the only anesthetic. Two of the 3 patients had difficulties: 1 was sensitive to multiple chemicals, had Addison disease, and had previously experienced anaphylactic reactions to local anesthetics; the other was allergic to lidocaine and had undergone a paradoxical reaction to pharmacologic sedation in the past. All 3 patients had 2 preoperative sessions each to assess their perioperative risk, level of anxiety, hypnotic susceptibility, and capacity to develop full hypnotic analgesia. On a surgery day, hypnosis was induced and hypnotic analgesia was obtained according to a standard protocol, a procedure taking no more than 9 minutes in each case. Each surgical procedure was then completed successfully with the patient in a painless condition of full relaxation and sense of well-being, with stable cardiovascular parameters. None of the patients required postoperative analgesics, which were prescribed for use as needed.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Hypnosis is a valuable tool in dentistry, enabling the safe and rapid relief of anxiety and phobia and raising patient pain thresholds to the level of surgical analgesia. Unlike drugs and equipment, it is always readily available, cost-free, and has no adverse effects when administered by competent professionals. Hypnosis can be used for sedation in most patients and as a stand-alone technique in those with appropriate hypnotic susceptibility, improving the well-being and safety of patients.

Hypnosis as Sole Anesthesia for Dental Removal in a Patient with Multiple Chemical Sensitivity

Despite a number of studies on hypnosis as analgesia and anesthesia in several medical conditions, case studies on patients with multiple chemical sensitivity (MCS) are still relatively few. This case study is about a female patient with MCS who underwent dental removal using hypnosis as the sole anesthesia. The paradigm in which we work is psychosocial genomics of clinical hypnosis. We used the mind-body transformations therapy, one of the clinical methods of the psychosocial genomics paradigm. In order to induce not only effective analgesia and anesthesia but also a condition of well-being, problem-solving, effective coping and self-empowerment in our patient, 3 different hypnotic protocols were used in a multidimensional approach. Although further research is needed, our work might open up new scenarios for the application of hypnosis as sole anesthesia in conditions such as MCS.

Integrating Clinical Hypnosis and Neurofeedback

Hypnosis and neurofeedback each provide unique therapeutic strengths and opportunities. This article provides an overview of some of the research on neurofeedback and hypnosis. The author's perspective and recommendations are provided on the relative clinical utility of using either neurofeedback or hypnosis as the initial treatment of choice with various clinical conditions.

Simple mastectomy under hypnosis: A case study approach

There is a clear inverse relationship between preoperative anxiety and effective anaesthesia and recovery. Studies have shown that perioperative anxiety can be detrimental to the efficacy of recovery. In order to mitigate the perioperative anaesthetic risk to the patient, perioperative care must be inclusive of psychological as well as physiological elements. Therefore, when planning and implementing care for the surgical patient alternative interventions, such as hypnosis, should be considered when presented with difficult patient factors, such as crippling anxiety. This article takes on a case study approach to critically analyse and appraise the holistic care of a patient undergoing a simple mastectomy with hypnosis as the primary anaesthesia.

A review of the history of hypnosis through the late 19th century

A review of the history of hypnosis through the late 19th century is provided in this article. The author offers an important review for practitioners of hypnosis preparing to take diplomate board examinations. Clinicians will also be enabled to trace the evolution of clinical methods, principles, and techniques.