New research presented at this year's Euroanaesthesia congress in Copenhagen, Denmark shows that hypnosedation is a valuable alternative to conventional general anaesthesia.
Hypnosedation is a technique which combines hypnosis, conscious sedation (where drugs are used to make the patient comfortable and relaxed while remaining conscious), and local anaesthesia to block pain. It has previously been shown to decrease the need for medication, reduce adverse effects, and to accelerate postoperative rehabilitation when compared to general anaesthesia in which the patient is rendered unconscious.
This research team led by Dr Aurore Marcou and colleagues from the Institut Curie, Paris, France, say: "By minimising effects of anaesthesia on vital functions while preserving the patients' well-being, it contributes to a sustainable development of anaesthesia."
The authors performed a retrospective study of 150 cancer patients who were treated at the Institut Curie between 2011 and 2017, and whose operations were performed under hypnosis. Procedures were conducted with the usual safety conditions and monitoring in place, however they excluded all premedication or hypnotic drugs. A continuous supply of the opioid remifentanil was given during each operation to keep the patients comfortable, and they were provided with the usual anti-sickness drugs and a painkiller as a preventative measure. Local or locoregional anaesthesia was performed depending on the type and location of surgery, but the patient remained conscious throughout the procedure.
Hypnosedation was used in breast surgeries (including total mastectomies), which represented 90% of the surgeries in this study, and also gynaecological surgeries, colonoscopies, and superficial plastic surgeries (representing 10% between them). The mean duration of procedures was 60 minutes (30 to 160 minutes), and the mean length of stay in the recovery room was 35 minutes. Patients were aged from 18 to 100 years with a mean of 60.5 years, with 22% older than 75 years. Individuals were grouped according to the severity of their condition, with 2% being classified as having severe cardiac, respiratory, or renal failures that seriously questioned the benefit of using traditional general anaesthesia.
The authors found that in 99% of cases, hypnosedation provided comfortable conditions for both the patient and the surgeon operating on them. Patient discomfort happened in just two cases, and in both of these, general anaesthesia was quickly and easily implemented.
The authors conclude that: "Hypnosedation can be proposed as a useful alternative to general anaesthesia in various types of surgeries including major breast surgeries. By minimising effects of anaesthesia, this technique is particularly valuable for vulnerable patients. Hypnosis benefits the patient as well as the caregivers."