We got this enthusiastic email about using guided imagery for a hysterectomy a while back:

"I was told about the Successful Surgery CD by an acquaintance and decided to try it before my surgery.

When I was in my 20's I learned self-hypnosis to alleviate my fear and it was invaluable during the labor of my first child. I wish I would have continued practicing it, but once used, I put it aside.

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. This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

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.

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.

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.

Citation: Dreher H. Mind-body interventions for surgery: evidence and exigency. Advances In Mind Body Medicine 1998;14:207-222.