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Science article - Hypnosis and Breast Sugery

According to the results of a random clinical trial, hypnosis performed on patients before breast surgery reduces the amount of medication required during the procedure and reduces pain and post-surgery nausea. Hospitals also benefit from a cost standpoint as surgery normally last less time.

These results were published in the Journal of the National Cancer Institute of September 5th. They are from a study of 200 patients followed in two surgeries at the Mount Sinai Medical Center in New York. The patients were scheduled to have a breast biopsy by excision or a lumpectomy, with or without limited dissection of auxilliary ganglions.

The patients were randomly assigned to hypnosis (n = 105) or to an "attention-control" procedure (n = 95). The two procedures were administered by one of four PhD-level clinical psychologists and lasted for 15 minutes in the hour before surgery. When they left the hospital, the patients used a visual analog scale (VAS) ranging from 1 to 100 to report post-surgery symptoms.

The patients in the hypnosis group required less lidocaine (average: 24.23 ml compared to 31.09 ml) and less propofol (64.01 µg compared to 96.64 µg) during their surgery than did the contol group.

Hypnosis reduced the intensity of post-surgical pain reported by patients (average VAS scores: 22.43 compared to 47.83) and produced less nausea (6.57 compared to 25.49). Patient evaluations of discomfort, fatigue, and emotional distress were also statistically significantly better with hypnosis. According to the researchers, all of the results were "clinically significant".

Dr Montgomery's group estimates that breast surgery procedures carried out at the Mount Sinai Medical Center cost on average $8,561 per patient. Hypnosis reduced that cost by $772.71 per patient.

"A brief hypnosis session seems to be one of the rare clinical procedures that reduces both symptoms and costs", they concluded.

In a related editorial, Dr David Spiegel, of the Stanford University School of Medicine in California, noted that the pain relief achieved with hypnosis was comparable to that achieved with many painkillers.

He wrote that "It is now abundantly clear that we can retrain the brain to reduce pain."

NEW YORK (Reuters Health)

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Marc MOREAU, 08/29/2007 - 5:54 pm
Source: J Natl Cancer Inst 2007;99:1304-1312.