Effects of Positive Suggestions on the Need for Red Blood Cell Transfusion in Orthopedic Surgery

This study examined whether positive suggestions applied without a hypnotic induction in the perioperative period reduces the need for red blood cell transfusions in patients who underwent total hip or knee arthroplasties with spinal anesthesia. No hypnotic assessment was performed. Ninety-five patients were randomly assigned to the suggestion group (n = 45) and to the control group (n = 50). Patients in the suggestion group received verbal suggestions before and audiotaped suggestions during the surgery for reducing blood loss, anxiety, postoperative pain, and fast recovery. Our study showed that using positive suggestions in the perioperative period significantly decreases the necessity for transfusion.

Shortening the length of stay and mechanical ventilation time by using positive suggestions via MP3 players for ventilated patients

Long stay in intensive care unit (ICU) and prolonged ventilation are deleterious for subsequent quality of life and surcharge financial capacity. We have already demonstrated the beneficial effects of using suggestive communication on recovery time during intensive care. The aim of our present study was to prove the same effects with standardized positive suggestive message delivered by an MP3 player. Patients ventilated in ICU were randomized into a control group receiving standard ICU treatment and two groups with a standardized pre-recorded material delivered via headphones: a suggestive message about safety, self-control, and recovery for the study group and a relaxing music for the music group. Groups were similar in terms of age, gender, and mortality, but the SAPS II scores were higher in the study group than that in the controls (57.8 ± 23.6 vs. 30.1 ± 15.5 and 33.7 ± 17.4). Our post-hoc analysis results showed that the length of ICU stay (134.2 ± 73.3 vs. 314.2 ± 178.4 h) and the time spent on ventilator (85.2 ± 34.9 vs. 232.0 ± 165.6 h) were significantly shorter in the study group compared to the unified control. The advantage of the structured positive suggestive message was proven against both music and control groups.

Therapeutic suggestion helps to cut back on drug intake for mechanically ventilated patients in intensive care unit

Research was conducted on ventilated patients treated in an intensive care unit (ICU) under identical circumstances; patients were divided into two groups (subsequently proved statistically identical as to age and Simplified Acute Physiology Score II [SAPS II]). One group was treated with positive suggestions for 15-20 min a day based on a predetermined scheme, but tailored to the individual patient, while the control group received no auxiliary psychological treatment. Our goal was to test the effects of positive communication in this special clinical situation. In this section of the research, the subsequent data collection was aimed to reveal whether any change in drug need could be demonstrated upon the influence of suggestions as compared to the control group. Owing to the strict recruitment criteria, a relatively small sample (suggestion group n = 15, control group n = 10) was available during the approximately nine-month period of research. As an outcome of suggestions, there was a significant drop in benzodiazepine (p < 0.005), opioid (p < 0.001), and the α2-agonist (p < 0.05) intake. All this justifies the presence of therapeutic suggestions among the therapies used in ICUs. However, repeating the trial on a larger sample of patients would be recommended.

Examples of positive suggestions given to patients undergoing orthopaedic surgeries

In the Department of Orthopaedic Surgery in the University of Debrecen, Debrecen, Hungary, we examined the effectiveness of positive suggestions used in the perioperative period in hip and knee arthroplasties performed under spinal anaesthesia. The goal of the suggestions was to reduce the need for red blood cell transfusion and for analgesics, and to increase the patients' satisfaction. The objective of this article is to present our method with concrete examples of positive suggestions which were given first before the surgery (via personal conversation), then during the operation as well (via audiotaped method). We hope that our article will contribute to the wide-spread awareness of this relatively easy to learn communication method.

Positive suggestion techniques in somatic medicine: A review of the empirical studies

INTRODUCTION

THERE IS AN EVER REOCCURRING QUESTION IN MEDICAL PRACTICE: Does the positive attitude and communication of the medical staff make any difference?

AIM

Our aim is to present a comprehensive overview of the medically relevant effects of positive suggestions by reviewing the recent literature.

METHODS

We will review the studies measuring the effects of suggestive communication of the past 20 years. In cases of studies presented in more details we quote from the suggestion scripts used in the study, too.

RESULTS

Some of the reviewed papers report that positive suggestions lead to decreased pain and use of pain medication and positively affect physiological factors like bowel motility, blood pressure and bleeding during surgery as well. However, the literature also contains studies in which only partial or no positive effects were found.

CONCLUSIONS

We emphasize further, more detailed investigation of positive suggestion techniques and its integration into the education of medical professionals.

[Positive suggestion techniques in somatic medicine]

There is a re-occurring question in medical practice: do positive attitude and communication of the medical staff make any difference?

AIM

Our aim is to present a comprehensive image of the medically relevant effects of positive suggestions by reviewing the recent literature.

METHODS

We review the studies measuring the effects of suggestive communication of the past 20 years. In cases of studies presented in more details we quote from the suggestion scripts used in the study, too.

RESULTS

Most of the reviewed papers affirm that positive suggestions lead to decreased pain and use of pain medication. But physiological factors like bowel motility, blood pressure and bleeding during surgery can be positively affected, too.

CONCLUSIONS

Suggestive communication - a yet poorly utilized tool - used appropriately can significantly affect healing and recovery of a patient. Thus we emphasize further, more detailed study of this technique and its integration into the education of medical professionals.

[Psychologists working as members of the intensive care team could reduce the length of stay]

Both short and long term outcome of mechanically ventilated patients are dependent on the time spent on ventilator and on the intensive care unit. Health related quality of life of the survival of intensive care has been proved to be related with the physical and psychological effects of the intensive care itself. In our previous multicenter randomized trial we have demonstrated the effect of psychological support delivered at the time of intensive care.

AIM

The aim of this post hoc analysis is to demonstrate the effect of the psychological support given by an ICU staff psychologist providing continuous care by the same therapist.

METHODS

36 patients were included in the post hoc analysis, 17 in the control and 19 in the treatment group. The treatment group received daily psychological support based on positive suggestions delivered by the same therapist at least in 50% of the time. The control group received the same ICU care but without the involvement of the psychologist. There were no differences between the two groups in age, sex, SAPSII score and basic medical treatment.

RESULTS

RESULTS showed a significant reduction in mechanical ventilation (3.6 days shorter, p < 0.014) and length of stay (4.2 days shorter, p < 0.022) of the treatment group compared to the control.

CONCLUSIONS

These results suggest the value of a psychologist working as a full member of the ICU team and providing supplementary psychological support of patients.