In several hospitals in Europe and the United States, hypnosis is used as a complement to local anesthesia, to reduce the dose of drugs in surgical interventions.
“Think of a nice, quiet and safe place and make yourself comfortable,” says a soft female voice, with a tone that invites you to calm down.
“Now, inhale very slowly and exhale very slowly, gently,” he continues, with the same serenity as at the beginning.
This entry is part of a series of audios posted on the Royal College of Anesthetists UK (RCoA) website. The agency recently issued a call for these recordings to be used more in the moments before surgery.
The idea is to lead the patient, through self-hypnosis, into a state of relaxation to reduce his level of anxiety before entering the operating room.
The aim of the recordings is also to serve as a “resource (designed, tested and modified in view of its results) to be offered to patients, rather than advising them to search for information on the internet”, according to BBC News Mundo (feature in Spanish from the BBC) pediatrician and anesthetist Samantha Black, who helped develop the audio.
Evidence indicates, she says, that this prior psychological preparation (along with ingesting nutritious food and practicing physical exercises) improves the outcomes of the intervention.
Other European countries and the USA have gone one step further: in some hospitals this technique is not used before but also during surgery.
Several studies and randomized clinical trials (some of them carried out in the United States, Belgium and France) have shown that the use of hypnosis – also called hypnosedation or hypnotherapy – helps to reduce the dose of anesthetics during surgery, thus such as time and the need for tranquilizers in the recovery period.
‘Strain the pain’
Hypnosis is a state in which attention is sharply focused. A person’s awareness of what is happening next to him is limited.
Generally, this state is achieved with the help of another person who guides us with their words until the hypnotic trance is induced. But it is also possible to practice self-hypnosis.
In the hypnotic state, the person is not asleep or unconscious, just relaxed.
“You disconnect, you dissociate from what is happening on the periphery of your consciousness and enter a state of cognitive flexibility,” explains Professor David Spiegel, from the Department of Psychiatry and Behavioral Sciences at Stanford University in the United States. “You are more open to trying ideas and having new experiences rather than your usual way of doing things.”
In the context of surgery, the patient is led to direct his attention away from his body. This technique is used “to restructure the experience of the surgical procedure,” he adds.
In other words, you train your brain to “filter the pain by literally ignoring the sensation and focusing on being somewhere else.”
Spiegel is a leader in clinical hypnosis research. He compares this state to watching a film that fascinates and absorbs us completely, to the point where we forget, for a few moments, that we are part of the audience, so absorbed are we in the drama unfolding on the screen.
The same process happens when we get in a car and drive somewhere, according to Professor Elizabeth Rebello, Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Texas (USA).
“As you drive, you think about what you need to do for the day, something about your family, and suddenly you realize you’ve arrived,” he explains. “That’s kind of what hypnosis does.”
effect on the brain
Technically speaking, hypnosis has three effects on the brain. Spiegel says he has observed these changes in functional magnetic resonance imaging (fMRI) studies during his research:
1. There is reduced activity in the dorsal anterior cingulate cortex, a region of the brain that helps us keep our attention on our surroundings.
2. Improves the connection between two brain regions (the dorsolateral prefrontal cortex and the insula). This “brain-body” connection helps the brain process and control what goes on in the body.
3. Connections between the dorsolateral prefrontal cortex and the neural network are reduced, possibly representing a disconnect between a person’s actions and awareness of one’s actions (as occurs when we are doing something without really thinking about what we are doing) . This dissociation allows the person to respond to instructions during hypnotherapy without dedicating mental resources to becoming aware of them.
Complement
The goal of proponents of the use of hypnosis in the operating room is not to replace general anesthesia with hypnotic sedation in highly complex surgical procedures. The intention is to use it as a complement in simpler and shorter operations, together with local anesthesia.
This is exactly what a team of doctors and researchers at the University of Texas MD Anderson Cancer Center has been doing for several years.
Rebello and his team use hypnosedation on patients undergoing lumpectomy, a surgery to remove a cancerous or abnormal lump from the breast. This procedure is usually done under general anesthesia.
Before hypnosis during the operation, patients who are open to this idea have previous sessions with the same practitioner.
When the patient enters the operating room, an interdisciplinary team is in constant communication and monitors his comfort levels, increasing medications or local anesthesia according to his needs.
“It’s a very safe environment, because we’re in an operating room,” Rebello explains. “And if you need to switch to general anesthesia, you have everything you need right there.”
He emphasizes that this is a viable option for some procedures, in a certain group of patients.
Benefits
The benefits of hypnosis are many, according to doctors consulted by BBC News Mundo.
In addition to reducing anxiety before and during the procedure, hypnosis helps reduce the dose of anesthesia and sedatives – and, consequently, the nausea, vomiting and other discomforts that plague many people.
Additionally, patients do not experience dizziness or numbness, as with general anesthesia, and are nearly ready to go home when the procedure is complete.
Elizabeth Rebello also points out that the use of hypnosis has the potential to reduce the consumption of opioids, which are needed in smaller doses during and after surgery.
Another benefit of avoiding general anesthesia whenever possible is that it “can cause short- and long-term cognitive impairment,” according to Lorenzo Cohen, director of the integrative medicine program at the University of Texas MD Anderson Cancer Center.
“And, in addition, there is evidence that it causes immunological suppression, which we don’t want to happen when we try to control the growth of cancer,” explains the doctor, referring to the tumoritectomies (surgeries to remove a lump) performed at his institution.
Disadvantages
With all of the benefits of hypnosedation, the question remains why it remains an underutilized clinical practice, even though it has gained traction in recent years.
One obstacle is that not everyone can be hypnotized.
“It’s a permanent trait, like IQ,” according to Spiegel. “Most people are susceptible to hypnosis to some extent. But there are 25% of adults who aren’t.”
He believes this variability may have genetic causes.
In addition, professionals must spend more time training patients preparing for surgery and monitor them more closely during the operation.
Other opposing opinions indicate that the use of hypnosis is not indicated for major surgical interventions, involving internal organs, and of long duration. In these cases, the pain would be unbearable.
And we cannot forget that, despite the numerous studies published in recognized scientific circles that confirm its effectiveness in certain contexts, hypnosis still carries an aura of pseudoscience, closer to the world of entertainment than to medicine, right from the ‘Victorian age.
“It still carries this stigma that connects hypnosis to past television shows rather than the medical world,” Samantha Black points out. But she believes that view is slowly changing as access to hypnosis increases and new practice training courses emerge for physicians and anesthesiologists.
David Spiegel believes that hypnosis is not used more widely in the medical field because, behind this methodology, there are no large pharmaceutical companies that profit from it.
“Part of the problem is that we don’t have a good economic model to spread this practice,” concludes the professor.
Source: Terra
Ben Stock is a lifestyle journalist and author at Gossipify. He writes about topics such as health, wellness, travel, food and home decor. He provides practical advice and inspiration to improve well-being, keeps readers up to date with latest lifestyle news and trends, known for his engaging writing style, in-depth analysis and unique perspectives.
-to2c6pqzbwaf.png "Polyna Rocha, Leonardo’s wife, reveals that he has “high spiritual sensitivity”")
