Positive Health Online

Abstract

MEURISSE and colleagues, Service de Chirurgie des Glandes Endocrines et Transplantation, Centre Hospitalier Universitaire de Liege, Belgium performed 108 thyroidectomies (97 partial or unilateral and 11 bilateral) and 13 cervical explorations for hyperparathyroidism under hypnosedation (HS) technique, which combines hypnosis and light conscious sedation.

Background

Methodology

Informed consent was obtained from each patient; none of these patients underwent preoperatively standard susceptibility test score or preparatory hypnotic session. Despite this, no patient required conversion to general anaesthesia . Operative data and postoperative courses were compared to a well-matched population (n = 70) of patients operated on for thyroid diseases using general anaesthesia (GA).

Results

with HS, mortality was zero and surgical management complicated only by unilateral definitive recurrent laryngeal nerve paralysis in one case and the need for neck reexploration for severe haematoma following parthyroidectomy in another case. In all cases hyperparathyroidism was cured. Surgeons all reported superior operating conditions for cervicotomy using HS, which is probably related to reduced bleeding within the operative field. All patients reported a very pleasant experience and enjoyed having their surgery performed under HS. Patients having HS had less postoperative pain, analgaesic consumption was significantly reduced in the HS group compared with the GA group, and hospital stay was significantly lower, resulting in a substantial reduction in medical care costs. Postoperative fatigue syndrome and surgical convalescence were significantly improved following HS; full return to social or professional activity was usually achieved after 10.3 days in the HS group compared to 36 days in the GA group.

Conclusion

: HS is a very effective technique for providing relief of intra- and postoperative pain in endocrine surgery. The technique results in high patient satisfaction and improved surgical convalescence. The technique can be used in most motivated patients and reduces the socioeconomic impact of hospitalisation.

References

Meurisse M et al. Endocrine surgery by hypnosis. From fiction to daily clinical application. Ann Endocrinol (Paris) 57(6): 494-501. 1996.