After one hypnosis session before a lumpectomy or breast biopsy, patients require 22% less analgesia and 34% less sedation; and report 53% less pain intensity, 74% less nausea, 46% less fatigue, 47% less discomfort, and 74% less emotional upset
Researchers from New York’s Mount Sinai School of Medicine randomly assigned 200 women scheduled for a breast biopsy or lumpectomy to a brief pre-surgical session of either supportive therapy or hypnosis. The hypnotic procedure included guided relaxation, the use of imagery, and symptom-focused suggestions. All the women were treated with anesthesia and pain medications during the procedures and given painkillers as needed afterward.
The study found that during surgery, the hypnotized women required 22% less analgesia and 34% less sedation. After surgery, they reported 53% less pain intensity, 74% less nausea, 46% less fatigue, 47% less discomfort, and 74% less emotional upset. They also spent 11 fewer minutes in surgery, resulting in a cost savings of almost $800 per patient.
The authors conclude that a brief, one-session hypnosis intervention appears to be one of the rare clinical interventions that can simultaneously reduce both symptom burden and costs.
Citation: Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH. A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Journal of the National Cancer Institute. 2007 Sep 5;99 (17): pages 1304-12. Epub 2007 Aug 28. firstname.lastname@example.org
A randomized, double blinded, placebo controlled study with 335 surgery patients at UC Davis (completed at Hershey College of Medicine at Penn. State)
randomly assigned one of five audio interventions to pre-surgery
patients undergoing lengthy surgeries. The tapes included Affirmations,
Hemi-Sync, Didactic Explanation, Guided Imagery and a control tape of
whooshing sounds. Outcomes revealed that most of the interventions
significantly reduced anxiety; but only the guided imagery
significantly reduced length of stay and blood loss. The Hemi-Sync tape
actually increased blood loss.
Citation: Bennett H, Dreher H,
Interventions for Surgery: Evidence and Exigency. Advances in Mind-Body
Medicine, Vol. 14, No. 3, 1998. HenDreh2@aol.com
Researchers at the Institute of Nursing and Midwifery at the University of Brighton
in the UK investigated the impact of foot massage and guided relaxation
on the well-being of patients who had undergone coronary artery bypass
graft (CABG) surgery.
There was a significant effect of the intervention on the calm scores
(ANOVA, P=0.014), mostly due to the massage, although to a lesser
extent due to the imagery. Dunnett''s multiple comparison showed that
this was attributable to increased calm among the massage group. There
was also a clear but non-significant trend across all psychological
variables for both foot massage and, to a lesser extent, guided
relaxation, for improving psychological well-being. Both interventions
were well received by the subjects.
Researchers at United Christian Hospital in Hong Kong compared
the effects of progressive relaxation with Qigong on improving the
quality of life in cardiac rehab patients.
A total of 65 subjects, with a mean age of 65 (range, 42 to 76), were
recruited for the study. Their cardiac diseases included myocardial
infarct, post-coronary intervention, valve replacement, and ischemic
heart disease. Patients were alternately allocated to two groups: the
first group of patients received instructions and practiced progressive
relaxation. The second group underwent training in qigong. A total of
eight sessions were conducted, each session lasting 20 minutes.
Once again, researchers - this time at the University of Wisconsin - find that nonpharmacologic, mind-body techniques reduce pain and anxiety in orthopedic patients undergoing elective knee or hip replacement surgery
In a randomized, controlled, clinical trial, researchers from the University of Wisconsin studied orthopedic patients undergoing elective knee or hip arthroplasty, comparing degrees of pain and anxiety in those who received a kit of nonpharmacologic strategies in addition to their regularly prescribed analgesics, to those receiving pharacologic management alone.
Sixty-five patients were randomized to receive usual care or usual care plus the kit of nonpharmacologic strategies. Patients who received the kit tended to use less opioid medications and have less anxiety on postoperative day 1 (but this was not statistically significant) and used significantly less opioid drugs on postoperative day 2 than the patients who did not receive the kit, in spite of no differences in pain intensity.
Researchers from Poliambulanza Hospital in Brescia, Italy, randomized 46 patients to receive either medical sedation (group 1) or hypnotic sedation (group 2) during percutaneous, transluminal coronary angioplasty of the left anterior descending coronary artery.
Intracoronary and standard electrocardiograms were continuously registered, and heart rate spectral variability was measured. Normalized units of low- and high-frequency components and the ratio of low to high frequency were measured during balloon inflations
British researchers find that foot massage and, to a lesser extent, guided relaxation, substantially improved calmness and well-being in post-op coronary bypass patients.
Researchers at the University of Brighton in East Sussex, UK, sought to identify a safe and effective therapeutic intervention that would promote well being in post-op patients recovering from coronary artery bypass graft (CABG) surgery - something that could easily and practically be provided by nurses on the floor. Foot massage and guided relaxation were the interventions chosen to be studied.
Henry Dreher''s superb summary of research with mind-body interventions for surgery appears in the Fetzer Institute''s Advances in Mind-Body Medicine, Vol 14, no.3, Summer 1998, pp. 207-222. His discussion of Henry Bennett''s placebo controlled, double blinded research with 4 audio interventions on 335 surgery patients establishes that the Health Journeys tape for Surgery was the only tape that offered statistically significant results. The study yielded profound results on the reduction blood loss, length of hospital stay and anxiety levels, both state (the fluctuating kind) and trait anxiety (which presumably doesn''t change, because it is seen as a relatively stable personality feature). In fact, the Naparstek guided imagery tape was so potent, that Dreher devotes a whole section of this article to trying to figure out why it outperformed all the others.
Citation: Dreher H. Mind-body interventions for surgery: evidence and exigency. Advances In Mind Body Medicine 1998;14:207-222.
At Columbia Presbyterian Medical Center, Ashton, Whitworth, et al found that patients who were taught self-hypnosis/relaxation techniques before undergoing first-time elective coronary artery bypass surgery were significantly more relaxed following the operation, as compared to a control group. They also used significantly less pain medication. Surgical outcomes were the same for both groups.
Citation: Ashton C Jr, Whitworth GC, et al. Self-hypnosis reduces anxiety following coronary artery bypass surgery. A prospective, randomized trial. J. Cardiovascular Surgery(Torino). 1997 Feb; 38(1): pp. 69-75.
Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery.
A 1995 study reported in Psychosomatic Medicine shows that of 51 patients undergoing abdominal surgery, those who were taught guided imagery before surgery had less postoperative pain than those who did not. They were also less distressed by the surgery, felt as if they had coped with it better and requested less pain medication than patients who did learn imagery skills.
Citation: Manyande A, Berg S, Gettins D, Stanford SC, Mazhero S, Marks DF, Salmon P. Preoperative rehearsal of active coping imagery influences subjective and hormonal responses to abdominal surgery. Psychosomatic Medicine. 1995: 57: 177-182.