Doctors are using hypnosis instead of anesthesia to keep patients calm during some surgeries in an effort to reduce the use of addictive and dangerous drugs.
A team of cross-disciplinary doctors at MD Anderson Cancer Center in Texas are teaching some patients to imagine themselves in calm environments while surgeons make incisions and perform operations.
Anesthesia has been linked to a number of worrisome side effects, such as memory loss and immune system suppression in the aftermath – sometimes for many months – of surgery.
Like recent efforts to phase out opioid painkillers, more and more doctors and patients are looking for ways to use less of the expensive and risky sedative.
Doctors are using a combination of local anesthesia and hypnosis to keep patients calm during surgery, instead of giving them general anesthesia that’s been linked to cognitive problems and weakened immune systems (file)
Anesthesia uses a cocktail of several drugs, delivered in gas form, to knock a patient unconscious.
Each day in the US, some 60,00 people have surgeries while under anesthesia.
It’s generally safe, with just 1.1 people dying of causes related to anesthesia for ever one million that go under each year.
But sleeping through surgery has varying effects – and for some they can linger.
Around 24 percent of people go through a period of delirium after waking from surgery under general anesthesia, according to a 2013 study conducted in China.
Some 15 percent of those said their symptoms lingered for at least three months after their operations.
And once people hit middle age, general anesthesia seems to hit the memory harder.
In fact one Duke University study from the early 2000s found that over half of patients who underwent bypass surgery suffered memory loss in the immediate aftermath of their operations.
They followed the patients for years afterwards, and found that 42 percent still showed cognitive declines five years after they’d been put under.
Of course, it’s difficult to suss out exactly to what extent these effects can be blamed on anesthesia.
But it’s enough to raise concerns for patients and doctors alike, who are increasingly trying to do more with less drugs on board.
‘The general goal is to try to decreases pharmacological agents we know can case harm to individuals by decreasing immune responses and [having] an impact on cognitive functioning,’ Dr Lorenzo Cohen, director of integrative medicine at MD Anderson told DailyMail.com.
‘If we can avoid giving general anesthesia, it’s better for the patients in the long-run.’
He and his team has been testing a particular kind of ‘procedural’ hypnosis to get help their patients dodge the dangers and hangovers of general anesthesia.
Hypnotherapists guide the thinking of patients by helping them to focus all five senses on the idea of a different, soothing place while doctors operate.
‘It’s similar to guided imagery, where you are encouraging individuals to create a scene with the guidance of a therapist to engage all five senses to really put yourself in a specific place,’ Dr Cohen explains.
‘The aspect that comes from hypnosis is as sort of disassociation.’
A hypnotherapist uses a soothing voice to help set the scene for the patient.
The two are supposed to have one meeting before the operation, but Dr Cohen says that quite often, scheduling issues mean that patient and hypnotherapist don’t meet until right before the surgery begins. In other words, the patients are totally untrained in this kind of intentional dissociation.
The vast majority of their trial patients are undergoing breast lumpectomies before beginning cancer treatment.
In addition to the hypnotherapy, Dr Cohen says a typical patient is administered a local anesthetic to numb the surgical area, and some get painkillers, too.
The idea of the hypnotherapy is to tap into the shared responses and network of fear and anxiety, Dr Cohen says.
Hypnotherapy, he says, has a ‘long history of being incorporated to decrease anxiety before people undergo surgery or breast biopsies.’
Now their trial of over 50 breast surgeries suggest it may be even more powerful.
And patients are on board.
‘A large percentage are open and interested in this approach to control the pain and the majority of it is through the local anesthetic, so they’re not going to experience pain, though there’s a tremendous overlap between pain and anxiety in the brain,’ Dr Cohen said.
‘By having the local on board and controlling the pain, it allows them to manage the anxiety and work through it.’
Though he says that certain long and extensive surgeries will likely never be candidates for hypnosedation, he and his team think the method can be employed beyond breast biopsies.
‘Now more than ever is a time to look at trying to include non-pharmalogical approaches alongside conventional care because the evidence is pretty clear that within the medical system we often over-treat and are doing too much,’ says Dr Cohen.
‘Anywhere we can decrease individual’s exposures to these types of drugs, the better.’
