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Hypnosis Aids Surgery and Replaces General Anesthesia

Doctors have recorded great success using hypnosis on patients undergoing complicated, high-risk surgery. At Dartmouth-Hitchcock Medical Center, doctors use hypnosis to reduce pain and nausea among epilepsy patients who have electrodes placed inside their skulls to detect the source of their seizures. At the University of California Davis Medical Center, doctors didn't even need to formally hypnotize spinal surgery patients in order to limit their blood loss during the operation. They simply told 41 patients that blood would flow away from their backs during spine surgery. These patients lost roughly 650 cc of blood on the operating table; others on standard sedation lost nearly twice that.

Robert Scott, 64, was hit by a truck when he was 4 years old, leaving him with a crushed bladder. Now, with a good-natured smile, the retired school custodian relies on hypnosis to cope with the minor but painful surgery he must routinely undergo. Scott comes to Beth Israel Deaconess Medical Center in Boston every 8 to 10 weeks to have a urinary catheter--which is attached to his kidney through a hole in his back--pulled out and replaced.

While a team of doctors and nurses in green scrubs gathers surgical equipment and readies the massive, whirring, x-ray-guided scope overhead, Scott lies on his stomach, listening to the softly delivered instructions of Gloria Salazar, MD, a radiologist and hypnotherapist. She sits by Scott's head, encouraging him to relax and imagine a place he'd rather be. "Your body needs to be here," she says gently. "But you do not." She reads to him from a script used on all hypnosis patients at the hospital. Scott closes his eyes, takes a series of deep breaths, and seems to drift off to sleep. As doctors insert a long guide wire into his back, Scott doesn't flinch. When they fish the 12-inch catheter out of his kidney and guide a new one down in its place, he doesn't seem to even notice.

"With other patients, we use intravenous pain medication," says attending radiologist Salomao Faintuch, MD, as he pulls the tube out. "But we know Mr. Scott responds well to hypnosis, so we use only local anesthesia." Sedatives such as Valium and morphine prolong operations and can cause complications, Faintuch adds, so it's better to do without if the patient can handle it.

Scott can handle it because he's whisked his mind far away from the doctors probing deep inside his body. "I have a meadow that I go to, and there's a pond, which I put ducks on," he says after Salazar guides him back to full consciousness with a reawakening cue. "I take my granddaughter fishing. We talk and play." Five years ago, when he got intravenous sedation instead of hypnosis, Scott says, "it felt like someone took a piece of steel and stuck it right into my kidney." Now, he says: "I feel a lot of pressure, but no pain." Does the meadow really exist? "No." Does the granddaughter? "Oh, yes," he says with a smile. "But she's only 2 months old."

This is no ordinary hospital ward, but then its director, Elvira Lang, MD, is not your average administrator. Lang, a radiologist and Harvard Medical School professor, has transformed the interventional radiology department at Beth Israel Deaconess--where MRIs, x-rays, and ultrasounds are used in unclogging arteries and shrinking tumors--into a 24-hour, hypnosis-on-request unit. Virtually any patient, undergoing nearly any procedure, can receive hypnosis-induced pain relief within minutes. ("We don't always use the 'H' word when we talk to patients," Faintuch confesses, "because they think of people on TV who do silly things. So we say relaxation exercises.")

In 2000, Lang published a groundbreaking study on surgical hypnosis that many physicians credit with helping to legitimize the technique's role in the operating room. The study traced the outcomes of 241 patients randomly assigned to receive hypnosis, standard anesthesia, or sympathetic (but non-hypnotic) care while undergoing minor surgery. Lang and her colleagues found that patients who were guided through hypnotic relaxation during surgery used 50% less pain and anti-anxiety medication, suffered 75% fewer complications, and left the operating room 17 minutes sooner than the other groups. In a follow-up study, Lang found that hypnosis is a cost saver,  too--halving the $638 sedation costs of minor surgery.

Lang suspects that hypnosis helps patients tolerate operations by stabilizing heart rate and blood pressure. She's looking to see if it can substitute for sedation in women undergoing needle biopsies for suspected breast cancer, women having uterine fibroid surgery, and patients receiving chemotherapy for malignant liver tumors. The studies, funded by the federal government, are not yet complete, but Lang says the preliminary results are encouraging.

Reproduced here from The Healing Power of Hypnosis by Alexis Jetter, PREVENTION, March 2006

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