[en] Between April 1994 and June 1997, 197 thyroidectomies and 21 cervical explorations for hyperparathyroidism were performed under hypnosedation (HYP) and compared to the operative data and postoperative courses of a closely-matched population (n = 121) of patients operated on under general anaesthesia (GA). Conversion from hypnosis to GA was needed in two cases (1%). All surgeons reported better operating conditions for cervicotomy using HYP. All patients having HYP reported a very pleasant experience and had significantly less postoperative pain while analgesic use was significantly reduced in this group. Hospital stay was also significantly shorter, providing a substantial reduction of the medical care costs. The postoperative convalescence was significantly improved after HYP and full return to social or professional activity was significantly shortened. We conclude that HYP is a very efficient technique providing physiological, psychological and economic benefits to the patient.
Disciplines :
Anesthesia & intensive care Surgery Alternative medicine
Author, co-author :
Meurisse, Michel ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Defechereux, Thierry ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Hamoir, Etienne ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Maweja, Sylvie ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Marchettini, P.
Gollogly, L.
Degauque, C.
Joris, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Faymonville, Marie ; Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Language :
English
Title :
Hypnosis with conscious sedation instead of general anaesthesia? Applications in cervical endocrine surgery.
ELLIOTSON J. Numerous cases of surgical interventions without pain in the mesmeric state. 1843 Lea and Blanchard (Eds), Philadelphia.
HOAREAU J. Les racines historiques. "Hypnose Clinique", 1992, Masson Eds, Paris, 3-10.
ESDAILE J. Mesmerism in India and its practical application in surgery and medicine. 1846. In : LONGMANS, BROWN, GREEN and LONGMANS (Eds.), London.
ANDERSON E. Preoperative preparation for cardiac surgery facilitates recovery, reduces psychological distress, and reduces the incident of postoperative hypertension. J Consult Clin Psychol, 1987, 55: 513-520.
BLACHER R. Brief psychotherapeutic intervention on the surgical patient, 1987. In: R. BEACHER (Ed.), The psychological experience of surgery. New York, Wiley, 207-220.
BLANKFIELD R. Suggestion, relaxation and hypnosis as adjuncts in the care of surgery patients : a review of the literature. Am J Clin Hypn, 1991, 33: 172-186.
HATHAWAY D. Effect of preoperative instructions on postoperative outcomes: a meta analysis. Int J Clin Exp Hypn, 1986, 35: 269-275.
HOLDEN-LUND C. Effects of relaxation with guided imagery on surgical stress and wound healing. Res Nurs Health, 1988, 3: 235-244.
SPANOS N. P., MC NEIL C., GWYNN M. I., STAM H. J. Effects of suggestion and distraction on reported pain in subjects high and low on hypnotic susceptibility. J Abnorm Psychol, 1984, 93: 277-284.
FAYMONVILLE M. E., FISSETTE J., MAMBOURG P. H., ROEDIGER L., JORIS J., LAMY M. Hypnosis as adjunct therapy in conscious sedation for plastic surgery. Reg Anesth, 1995, 20: 145-151.
FAYMONVILLE M. E., MAMBOURG P. H., JORIS J., VRIJENS B., FISSETTE J., ALBERT A., LAMY M. Psychological approaches during conscious sedation. Hypnosis versus stress reducing strategies: a prospective randomized study. Pain, 1997, 73: 361-7.
FAYMONVILLE M. E., FISSFTTE J., MAMBOURG P. H., DELCHAMBRE A., LAMY M. Hypnose, hypnosedation: conceptions actuelles et leurs applications en chirurgie plastique. Rev Med Liege, 1994, 44: 13-21.
MEURISSE M., FAYMONVILLE M. E., DFFECHERFUX T., NGUYEN DANG D., JORIS J., HAMOIR E. Chirurgie thyroïdienne et parathyroïdienne sous hypnose: de la fiction à l'application clinique quotidienne. Ann. Endocrinol (Paris), 1996, 57: 494-501.
ERICKSON M. H. The interpersonal hypnotic technique for symptom correction and pain control. Am. J. Clin. Hypn. 1966, 8: 198-209.
ERICKSON M. H. Hypnosis, its renaissance as a treatment modality. Am J Clin Hypn, 1970, 13: 71-89.
ANSSEAU M. Intérêts des "Visual Analogues Scales" dans l'autoévaluation de l'anxiété. Feuillets Psych. Liège, 1984, 17: 14-19.
BOND A., LADER M. The use of analogue scales in rating subjective feelings. Br J Med Psychol, 1974, 47: 211-218.
PALMER D. G., BRUCE A. G., MEEK A. P., MYERS D. B. Meek grip analyser. Mol Biol Eng Comput, 1987, 20: 772-774.
BENNET H. L. The mind during surgery: the uncertain effects of anesthesia. Adv J Mind Body Health, 1993, 9: 5-16.
EGBERT L. D., BATTIT G. E., WELCH C. E., BARTLETT G. E. Reduction of postoperative pain by encouragement and instructions of patients. N Engl J Med, 1964, 270: 825-7.
JOHNSTON M., VOGELE C. Benefits of psychological preparation for surgery: a meta-analysis. Ann Behav Med, 1993, 15: 245-256.
LESERMAN J., STUART E. M., MARMISH M. E., BENSON H. The efficacy of the relaxation response in preparing for cardiac surgery. Behav Med, 1989, 5: 111-7.
MUMFORD E., SCHLESINGER H., GLASS G. The effects of psychological intervention on recovery from surgery and heart attacks : an analysis of the literature. Am J Publ Health, 1982, 72: 141-151.
ROGERS M., REICH P. J. Psychological intervention with surgical patients : evaluation outcome. Adv Psychosom Med, 1986, 15: 23-50.
SURMAN O. S., HACKETT T. P., SILVERBERG E. L., BEHRENDT D. M. Usefulness of psychiatric interventions in patients undergoing cardiac surgery. Arch Gen Psychiatry, 1974, 30: 830-5.
DISBROW E., BENNETT H., OWINGS J. Effect of preoperative suggestion on postoperative mobility. West J Med, 1993, 158: 488-92.
RAPKIN D. A., STRAUBING M., HOLROYD J. C. Guided imagery, hypnosis and recovery from head and neck cancer surgery: an exploratory study. Int J Clin Exp Hypn, 1991, 39: 215-226.
ASHTON C., WHITWORTH G. C., SELDOMRIDGE J. A., SHAPIRO P. A., WEINBERG A. D., MICHLER R. E., SMITH C. R., ROSE E. A., FISHER S., OZ M. C. Self-hypnosis reduces anxiety following coronory artery bypass surgery. J Cardiovasc Surg, 1997, 38: 69-75.
FEE W. E. Jr. Thyroidectomy under local anaesthesia, 1990. In: FALK S. A. (Ed.) Thyroid disease: Endocrinology, Surgery, Nuclear medicine and Radiotherapy, Raven Press, Ltd, New York, 585-586.
DITKOFF B. A., CHABOT J., FEIND C., LO GERFO P. Parathyroid surgery using monitored anesthesia care as an alternative to general anesthesia. Am J Surg, 1996, 172: 698-700.
BARBER J. Hypnosis and the hypnotizable. Am J Clin Hypn, 1980, 23: 4-9.
CLAWSON T. A., SWADE R. H. The hypnotic control of blood flow and pain : the cure of warts and the potential for the use of hypnosis in the treatment of cancer. Am J Clin Hypn, 1975, 17: 160-169.
GRABOWSKA M. J. The effect of hypnosis and hypnotic suggestion on the blood flow in the extremities. Pol Med J, 1971, 10: 1044-1051.
BEECHER H. K. Relationship of significance of wound to pain experience. JAMA, 1956, 16: 1609-1613.
MILLER M. E., BOWERS K. S. Hypnotic analgesia and stress inoculation in the reduction of pain. J. Abnorm. Psychol., 1986, 95: 6-14.
PRICE D. D., BARBER J. An analysis of factor that contribute to the efficacy of hypnotic analgesia. J. Abnorm. Psychol, 1987, 96: 46-51.
MAQUET P., FAYMONVILLE M. E., DEGUELDRE C., DELFIORE G., FRANCK G., LUXEN A., LAMY M. Functional neuroanatomy of hypnotic state. Biol Psychiatry, 1998 (in press).
ENQVIST B. L. Preoperatve hypnotherapy and preoperative suggestions in general anaesthesia : somatic responses in maxillo-facial surgery. Hypnos, 1991, 2: 72-77.
KESSLER R., DANE J. R. Psychological and hypnotic preparation for anaesthesia and surgery: an individual differences perspective. Int J Clin Exp Hypn, 1996, 44: 189-207.
KULKARNI R. S., BRAVERMAN L. E., PATWARDHAN N. A. Bilateral carvical plexus block for thyroidectomy and parathyroidectomy in healthy and high risk patients. J Endocrinol Invest, 1996, 19: 714-18.
MEURISSE M., HAMOIR E., DEFECHEREUX Th., GOLLOGLY L., DETRY O., POSTAL A., JORIS J., FAYMONVILLE M. E. Bilateral neck exploration under hypnosedation. A new standard of care in primary hyperparathyroidism? Ann Surg, 1998, 229: 401-408.
