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A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surge

19 Oct
Researchers from the Mount Sinai School of Medicine in New York find that a brief, pre-op session of hypnosis reduces anesthesia use, pain intensity, pain unpleasantness, nausea, fatigue, discomfort, and emotional upset in breast biopsy patients…
Researchers from the Mount Sinai School of Medicine in New York carried out a randomized clinical trial to see if a brief pre-surgery hypnosis intervention was able to decrease use of intra-operative anesthesia and analgesics as well as side effects associated with breast cancer surgery. Cost effectiveness was also assessed.

The study randomly assigned 200 patients, scheduled to undergo excisional breast biopsy or lumpectomy (mean age 48.5 years), to a 15-minute pre-surgery hypnosis session conducted by a psychologist or to the control condition, a session of nondirective empathic listening.

Intra-operative anesthesia use (the analgesics lidocaine and fentanyl and the sedatives propofol and midazolam) was assessed. Patient-reported pain and other side effects, as measured on a visual analog scale (0-100), were assessed at discharge, as was use of analgesics in the recovery room. Institutional costs and time in the operating room were measured via chart review.

Patients in the hypnosis group required significantly less propofol and lidocaine than patients in the control group. Patients in the hypnosis group also reported less pain intensity, pain unpleasantness, nausea, fatigue, discomfort, and emotional upset. No statistically significant differences were seen in the use of fentanyl, midazolam, or recovery room analgesics.

Institutional costs for surgical breast cancer procedures were $8561 per patient at Mount Sinai School of Medicine. Patients in the hypnosis group cost the institution $772.71 less per patient than those in the control group, mainly due to reduced surgical time.

The study concludes that hypnosis was superior to the control condition, with regard to propofol and lidocaine use; pain, nausea, fatigue, discomfort, and emotional upset at discharge; and institutional cost. Overall, the present data support the use of hypnosis with breast cancer surgery patients.

Citation: Montgomery GH, Bovbjerg DH, Schnur JB, David D, Goldfarb A, Weltz CR, Schechter C, Graff-Zivin J, Tatrow K, Price DD, Silverstein JH. A randomized clinical trial of a brief hypnosis intervention to control side effects in breast surgery patients. Journal of the National Cancer Institute. 2007 Sep 5; 99 (17): pages 1304-12. Epub 2007 Aug 28. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award