NEW YORK (Reuters Health) – Hypnosis before breast surgery reduces the amount of medication required during the procedure and lessens postsurgical pain and nausea, according to results of a randomized clinical trial. Hospitals also benefit cost-wise from the intervention as a result of the shortened duration of surgery.
These findings, reported in September 5th issue of the Journal of the National Cancer Institute, stem from a study of 200 patients recruited from two Mount Sinai Medical Center surgical practices in New York. They were scheduled to undergo excisional breast biopsy or lumpectomy, with or without limited axillary node dissection.
Patients were randomized to hypnosis (n = 105) or to a control intervention of nondirected empathic listening (n = 95). Both interventions were administered for 15 minutes within the hour prior to surgery by one of four PhD-level clinical psychologists. At discharge, patients used a 1-100 visual analogue scale (VAS) to report their postsurgical symptoms.
Patients in the hypnosis group required less lidocaine (mean 24.23 mL versus 31.09 mL), and less propofol (64.01 µg versus 96.64 µg) during surgery than patients in the control group, Dr. Guy H. Montgomery and colleagues report.
The hypnosis intervention reduced patient-reported postsurgical pain intensity (mean VAS scores 22.43 versus 47.83) and nausea (6.57 versus 25.49). Patients’ assessments of discomfort, fatigue, and emotional upset were also statistically significantly better after hypnosis. According to the investigators, all outcomes were “clinically meaningful.”
Dr. Montgomery’s team estimates that surgical breast procedures at the Mount Sinai Medical Center cost on average $8561 per patient. The hypnosis intervention reduced that cost by $772.71 per patient.
“A brief hypnosis intervention appears to be one of the rare clinical interventions that can simultaneously reduce both symptom burden and costs,” they conclude.
In a related editorial, Dr. David Spiegel from Stanford University School of Medicine in California, remarks that pain relief provided by hypnosis changes pain experience as much as many analgesic medications.
“It is now abundantly clear that we can retrain the brain to reduce pain,” he writes.