Case ReportHypnopraxia, a new hypnotic technique for hypnoanesthesia☆
Introduction
Hypnosis was the first technique used successfully in modern times for surgical anesthesia: the Scottish surgeon Esdaile published in 1852 a series of more than 300 serious operations carried out under hypnoanesthesia in India [1]. This was for the most part rapidly forgotten when drug-induced anesthesia was invented in the second half of the 19th century. Hypnotic techniques started to be reintroduced in anesthesia a century later, thanks to the work of several teams, and in particular Faymonville et al [2]. Hypnosis is now used in all sorts of surgical and medical procedures, whether as the sole anesthetic technique or as an adjunct to drug-induced sedation. Standard hypnotic techniques usually include suggestions to relax, to imagine a “special or safe place,” and suggestions for pain and anxiety control. Faymonville et al [2] use the reviviscence of pleasant life experiences as a substratum for hypnosis. The work here reports on the introduction of hypnopraxia in anesthesia. This new hypnotic technique was developed by Chedeau et al [3] for hypnotherapy. First published in 2005 at the 4th World Congress of Psychotherapy, it is derived from Ericksonian hypnosis, and drew its inspiration from phenomenological writings and in particular those of Henry [4]. Although it may appear to be technically simpler than other hypnotic techniques used in hypnoanesthesia, it requires a greater involvement for the anesthetist accompanying the patient.
Section snippets
Hypnopraxia
Hypnopraxia is a hypnotic technique which has evolved from traditional Ericksonian hypnosis. It was inspired by phenomenology. A “phenomenon” [5] is the act of something appearing in one's consciousness or experience. The structure of these experiences involves intentionality; the human mind unconsciously selects what will be allowed to appear in the consciousness. Two people experiencing a same event will not experience the same phenomena. People express their intentionalities in their
Results
Five patients underwent 6 procedures, 1 patient having had 2 procedures using hypnoanesthesia, a colonoscopy followed 1 month later by a transobturator tape procedure. Three other patients in the same period had wished to undergo a colonoscopy with hypnoanesthesia. Their motivation was not adequate, and they decided to have drug sedation rather than hypnoanesthesia after their first or second hypnopraxia session: 1 had been contraindicated for general anesthesia by another anesthetist who did
Discussion
Various hypnotic techniques have been introduced in anesthesia. One such technique is hypnopraxia. Its main advantage is its apparent simplicity; the patient does not need to imagine anything, or to learn a technique. He just needs to live the present moment in his body, although being accompanied by a trained anesthetist who acts as a sort of mirror for the patient. It is for this reason that, as for all hypnoanesthesia, the patient's motivation is essential. Just wishing to avoid drug-induced
Acknowledgments
This study had no funding whatsoever, and there were no financial ties between the two authors.
References (5)
Hypnosis and surgery: past, present, and future
Anesth Analg
(2007)- et al.
Hypnosedation: a valuable alternative to traditional anaesthetic techniques
Acta Chir Belg
(1999)
Cited by (2)
Prostate brachytherapy under hypnosedation: A prospective evaluation
2019, BrachytherapyCitation Excerpt :HS has been used for endocrine cervical surgery (12), bilateral neck explorations (13), plastic surgery (14, 15), evacuation of postpartum vulvar hematoma (16), implant placement procedure for women (17), extraction of third molars (18), breast cancer surgery (in combination with paravertebral block) (19), cholecystectomies and inguinal hernia repair (20) and skin tumor removal (21). HS may reduce bleeding, postoperative recovery time, pain medication, as well as potential side effects related to anesthesia and emotional distress (7,13–15,22–24) and can stabilize respiratory motion (25). Hypnotherapy has also been used with external beam radiotherapy to reduce anxiety, to improve the quality of treatment delivery and the quality of life in patients with cancer undergoing such therapy (25–28).
Do we really need an anesthesiologist for routine colonoscopy in American Society of Anesthesiologist 1 and 2 patients?
2018, Current Opinion in Anaesthesiology
- ☆
Statement of disclosure or conflict of interest: none.
- 1
Tel.: +41 22 759 04 76, +41 79 359 99 20 (Mobile).