AANS Neurosurgeon | Volume 26, Number 2, 2017

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Hypnosis May Provide New Option for Awake Craniotomy

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A new “hypnosedation” technique discussed in a study published in the journal Neurosurgery explores hypnosis as a way to reduce the psychological trauma associated with awake craniotomy procedures. During the study, researchers evaluated their hypnosis technique in 37 patients undergoing awake craniotomy, mainly for low-grade gliomas, between 2011 and 2015. Preparation for hypnosis began a few weeks before each surgery. The anesthesiologist and hypnotist met with the patient to carry out a short hypnosis session and teach the patient how to create a “safe place” — an imaginary place where they can feel safe and effective.
In the operating room, patients were placed in a hypnotic trance and were instructed to “let go” and to “separate the mind and body.” The hypnotic experience was progressively enhanced during the first steps of surgery, including specific instructions and imagery for each potentially unpleasant or painful step of the surgery. (The full article includes a detailed description and video of the hypnosedation procedure.) Results of the study showed that hypnosedation seemed to reduce the impact of unpleasant events during surgery. Some patients reported high-stress levels, but this did not appear to affect their subjective experience of hypnosis. The one patient who showed signs of post-traumatic stress disorder after surgery had a particularly good experience with hypnosis. For many patients, the most unpleasant parts of surgery were steps involving noise and vibration. Pain seemed to decrease as the level of hypnosis deepened. Only two patients said they would not choose to undergo hypnosedation if they had to undergo a second awake craniotomy. To read more about this study, click here.

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