Created May 21, 2015, last updated 4 months ago.
Collection: 13, Score: 716, Trend score: 0, Read count: 717, Articles count: 8, Created: 2015-05-21 02:14:00 UTC. Updated: 2021-02-11 10:48:20 UTC.
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Hypnosis has a long history of use for anesthesia and pain management, as well as in assisting patient to prepare for medical procedures. This article reviews the history of hypnosis applications in clinical medicine and dentistry. ⋯ Persons low in hypnotic ability may benefit from alternative therapeutic interventions; however, the majority of medical patients will benefit from the integration of adjunctive hypnotic therapies into their medical and dental care. The article closes with a discussion of the stronger evidence-based applications of hypnosis in healthcare, and the need for well-trained certified hypnosis practitioners.
Hypnosis is a physiological mind activity characterized by focused attention, absorption, dissociation and plastic imagination. In the early 19th century, several hundred surgical interventions were described with hypnosis as the sole anesthetic, in an epoch when no anesthetic drugs were available; then hypnosis was prejudicially abandoned and forgotten after its introduction. In the past two decades, an increasing number of studies on hypnosis has shown its capacity to modify the activity of the prefrontal cortex, default mode network and pain neuromatrix (including the anterior cingulate cortex, amygdala, thalamus, insula and somatosensory cortex) and increase pain threshold up to the level of surgical anesthesia. ⋯ The wealth of data available in the literature provides clear evidence of its meaningful effects on perioperative emotional distress, pain, medication consumption, physiological parameters, duration of surgery and outcome. Hypnosis may be used as follows: 1) as sole anesthetic, in minor surgery and invasive maneuvers and/or selected patients; 2) as adjuvant of pharmacological anesthesia (local anesthesia and/or sedation); 3) as an adjuvant technique in both pre- and postoperative phases in patients submitted to general anesthesia. Hypnosis, unlike any other therapeutic tools, does not call for drugs or equipment and is an attractive technique: it is free of charge, not burdened with proved adverse events and promises to help improving cost/benefits ratio.
Clinical evidence for the effectiveness of hypnosis in the treatment of acute procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. ⋯ However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions.
Review Meta Analysis
Randomized Controlled Trial Multicenter Study
Hypnosis is now widespread in medical practice and is emerging as an alternative technique for pain management and anxiety. However, its effects on postoperative outcomes remain unclear. ⋯ The results of this study do not support a benefit of hypnosis on postoperative breast pain in women undergoing minor breast cancer surgery. However, other outcomes seem to be improved, which needs to be confirmed by further studies.
Pediatric hypnosis has a useful role in pre-, peri-, and post-anesthesia to minimize anticipatory anxiety, and as adjunctive treatment to reduce and control pain. This article reviews the literature in the use of hypnosis in pediatric anesthesia to highlight its role and relevancy. ⋯ Patients in hypnosis treatment conditions have less anxiety and shorter hospital stays and experience less long-term pain and discomfort than do patients in control conditions. There appears little reason not to provide hypnosis as an adjunctive treatment for pediatric patients undergoing anesthesia.
Hypnosis is a well validated treatment for acute and chronic pain (Montgomery, DuHamel, & Redd, 2000). It has been found capable of reducing inflammation, altering blood flow, and producing beneficial effects when hypnotic suggestions are provided during and prior to surgery (Frederick, 2001) and other painful medical procedures. This paper quotes extensively from historical examples of the use of hypnosis (mesmerism) as the sole anesthesia for major surgeries in the 1800's. These historic examples by themselves provide powerful documentation of the ability of the mind to influence the body, but they are then followed by a review of contemporary literature and controlled research on the use in hypnosis in relation to surgery and prior to medical procedures.
Hypnosis has been defined as the induction of a subjective state in which alterations of perception or memory can be elicited by suggestion. Ever since the first public demonstrations of "animal magnetism" by Mesmer in the 18th century, the use of this psychological tool has fascinated the medical community and public alike. The application of hypnosis to alter pain perception and memory dates back centuries. ⋯ Contemporary clinical investigators claim that the combination of analgesia and hypnosis is superior to conventional pharmacologic anesthesia for minor surgical cases, with patients and surgeons responding favorably. Simultaneously, basic research of pain pathways involving the nociceptive flexion reflex and positron emission tomography has yielded objective data regarding the physiologic correlates of hypnosis. In this article I review the history, basic scientific and clinical studies, and modern practical considerations of one of the oldest therapeutical tools: the power of suggestion.
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