A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients.
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BACKGROUND: Breast cancer surgery is associated with side effects, including postsurgical pain, nausea, and fatigue. We carried out a randomized clinical trial to test the hypotheses that a brief presurgery hypnosis intervention would decrease intraoperative anesthesia and analgesic use and side effects associated with breast cancer surgery and that it would be cost effective. METHODS: We randomly assigned 200 patients who were scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years) to a 15-minute presurgery hypnosis session conducted by a psychologist or nondirective empathic listening (attention control). Patients were not blinded to group assignment. Intraoperative anesthesia use (i.e., of the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects as measured on a visual analog scale (0-100) were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were assessed via chart review. RESULTS: Patients in the hypnosis group required less propofol (means = 64.01 versus 96.64 microg; difference = 32.63; 95% confidence interval [CI] = 3.95 to 61.30) and lidocaine (means = 24.23 versus 31.09 mL; difference = 6.86; 95% CI = 3.05 to 10.68) than patients in the control group. Patients in the hypnosis group also reported less pain intensity (means = 22.43 versus 47.83; difference = 25.40; 95% CI = 17.56 to 33.25), pain unpleasantness (means = 21.19 versus 39.05; difference = 17.86; 95% CI = 9.92 to 25.80), nausea (means = 6.57 versus 25.49; difference = 18.92; 95% CI = 12.98 to 24.87), fatigue (means = 29.47 versus 54.20; difference = 24.73; 95% CI = 16.64 to 32.83), discomfort (means = 23.01 versus 43.20; difference = 20.19; 95% CI = 12.36 to 28.02), and emotional upset (means = 8.67 versus 33.46; difference = 24.79; 95% CI = 18.56 to 31.03). No statistically significant differences were seen in the use of fentanyl, midazolam, or recovery room analgesics. Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group (95% CI = 75.10 to 1469.89), mainly due to reduced surgical time. CONCLUSIONS: Hypnosis was superior to attention control regarding propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients. (+info)
Hypnosis for treatment of pain in children.
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QUESTION: Many children suffer from chronic and painful illnesses. Hypnosis was found to be effective for analgesia in adults. Is it effective for managing pain in children? ANSWER: Children can be easier to hypnotize than adults. Studies have shown clinical hypnosis and self-hypnosis to be effective as adjunct treatments for children in pain. Examples include painful medical procedures, such as bone marrow aspiration and lumbar puncture in pediatric cancer patients, postoperative pain and anxiety in children undergoing surgery, and chronic headache. (+info)
Mesmerizing memories: brain substrates of episodic memory suppression in posthypnotic amnesia.
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Potential applications for alternative medicine to treat obesity in an aging population.
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Obesity is a growing problem causing significant morbidity and mortality. The efficacy of conventional therapies is limited. Numerous alternative therapies are advocated for weight loss, including dietary modifications, hypnotherapy, and acupuncture. Many herbal medications and dietary supplements such as conjugated linoleic acids, chitosan, Garcinia cambogia, and Citrus aurantium, are also being used. Most have been tested in very limited trials. None have been evaluated to the extent they can be definitively recommended, nor have they been studied to ascertain the extent of potential hazards. Given the scope of the problem, and the potential risk to a vulnerable population, further research should be conducted to define the efficacy of these treatments, particularly for the elderly. (+info)
A systematic review of randomized controlled trials examining psychological interventions for needle-related procedural pain and distress in children and adolescents: an abbreviated cochrane review.
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Beneficial effects of hypnosis and adverse effects of empathic attention during percutaneous tumor treatment: when being nice does not suffice.
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Helping children and adults with hypnosis and biofeedback.
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Hypnosis and biofeedback are cyberphysiologic strategies that enable subjects to develop voluntary control of certain physiologic processes for the purpose of improving health. Self-hypnosis has been used with and without biofeedback for a wide range of therapeutic applications, and both laboratory studies and clinical trials have shown it to be effective in improving symptoms and outcomes in various disorders. More formal Cochrane reviews of hypnotherapeutic interventions are currently under way. Thorough patient assessment should precede training in self-hypnosis in order to properly tailor training strategies to patient preferences and characteristics, especially for children. Workshops offered by various clinical societies are available to train health professionals in self-hypnosis. (+info)