When renowned surgeon John Collins Warren announced to an enraptured audience that the use of anesthesia was “no humbug” in the first-ever public demonstration of the technique, 170 years ago, he was bringing to fruition a medical miracle. Before modern anesthesia, surgery was a gruesome affair — doctors tried to alleviate their patient’s pain through alcohol, opium, and blows to the jaw, to little salubrious effect. Now another surgical technique is gaining traction in medicine: hypnosis.
In 1846 a Scottish surgeon named James Esdaile announced that he could perform procedures using hypnosis as the sole anesthetic but the idea essentially laid dormant until the 20th century. Some hospitals, predominantly in Europe, began to offer hypnosis plus a small dosage of a local anesthetic as a surgical option as early as 1992 while a handful of studies have been produced that have argued that the benefits of hypnosis shouldn’t be ignored. Why the slow uptake? It’s mostly a problem with the messaging.
“It has taken us a century and a half to rediscover the fact that the mind has something to do with the pain and can be a powerful tool in controlling it,” wrote Stanford School of Medicine professor David Spiegel in the Journal of the National Cancer Institute. “There is still lingering suspicion that hypnosis reeks of stage show trickery.”
However, a recently released study may add credibility to the role of hypnosis in surgery. From May 2011 to April 2015, a team of French surgeons worked with 37 patients who needed to undergo a craniotomy for gliomas, a specific type of brain tumor. While hypnosis didn’t work for six of the patients and two decided they did not want to include hypnosis in their further surgeries, the surgeons behind the study believe that this research proves that “hypnosedation” can be a valuable tool for patients with advanced brain cancers.
If you don’t get queasy about having a full look at brain surgery, you can see the hypnotist working with a patient in the surgical room here. Essentially, the procedure for hypnosedation is this: Prep for each patient began a few weeks before the surgery, with sessions where the anesthesiologist/hypnotist worked the patient to create a mental, imaginary place that would make them feel safe. Once in the operating room, the patients were placed in a hypnotic trance induced by “eye fixation.” As each step of the surgery occurred the hypnotist (ready to provide an anesthetic if things went wrong) said aloud specific instructions and detailed imagery. If the patient perceived a noise, they were told to accept it as a boat’s engine; when a catheter was inserted, they were asked to imagine a metaphor of colored energy in their lower body.
This method of hypnosedation is a technique specifically for patients undergoing “awake surgery” — a common method for brain surgery. Awake surgeries are necessary because the neurosurgeons are removing tumors that are too close to areas of the brain that control vision, language, and body movements — they need to be able to check in with the patient during surgery to make sure these vital abilities are intact. Usually surgeries are preformed with some use of general anesthesia, such as the asleep-awake-asleep technique.
Hypnosis has the potential to be a better option than these anesthesia-combinations because patients recover faster, need fewer painkillers, and retain more awareness. In this recent study, hypnosedation appeared to reduce the “impact of unpleasant events during surgery” and overall, was a positive experience for the majority of patients.
“An important advantage of hypnosedation is that it allows the patient to remain awake throughout surgery,” the research team said in a press release. “This avoids the need to awaken the patient in the middle of standard ‘asleep-awake-asleep’ anesthesia — which can be especially challenging in patients with high-grade gliomas.”
While the team believes that their work is an encouraging step for hypnosedation, they are not yet convinced it is superior to standard anesthesia quite yet. The process is long and hasn’t yet been proved to be effective for everyone. Yet, as the oldest Western form of psychotherapy, hypnosis may very well be on the up and up. And, even better, hypnosis used for surgery patients is 100 percent less annoying than the hypnosis used at Senior Grad Nights.