Article
Clinical hypnosis in neurosurgery
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Authors
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Fabian Bünger
- Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
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Rupert Reichart
- Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
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Aaron Lawson McLean
- Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
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Jan Walter
- Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
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Rolf Kalff
- Universitätsklinikum Jena, Klinik für Neurochirurgie, Jena, Deutschland
| Published: | June 18, 2018 |
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Outline
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Objective: Hypnosis and surgery have been interlinked for hundreds of years, mainly through the use of clinical hypnosis to facilitate operative procedures. Hypnosis is also an established therapeutic modality in the treatment of pain. However, the integration of hypnotic techniques in the practice of neurosurgery, beyond mere perioperative hypnotic suggestion, is a relatively new development. This study explored the indications for clinical hypnosis in the neurosurgical service of a large university teaching hospital.
Methods: We examined patient records to retrospectively investigate the demographic and clinical characteristics of consecutive patients who underwent hypnotherapy in our neurosurgical department between November 2015 and November 2017. The treatment indications and outcomes of hypnotherapy were evaluated on a per-patient basis.
Results: During the study period, 56 patients underwent hypnotherapy, with a total of 154 hypnotherapy sessions conducted. 14/154 sessions involved perioperative hypnotic suggestion. Of these, five sessions took place during deep brain stimulation surgery. These perioperative hypnotic sessions were without complication and for some operations sedation could be omitted completely.
Eight awake patients hospitalized following aneurysmal subarachnoid hemorrhage received multiple sessions of hypnotherapy in an attempt to treat vasospasm. In 5/8 of these patients a reduction in vasospasm was demonstrated directly after hypnotherapy by means of transcranial Doppler ultrasonography.
Six patients who had suffered traumatic spinal cord injury received hypnotherapy with the aim of enhancing nerve regeneration. All of these patients reported a positive subjective global response to hypnotherapy, with the caveat that objective, long-term evidence is difficult to achieve in this context.
A further 32 patients underwent hypnotherapy to complement ongoing pain therapy on either an in- or outpatient basis. Here, patient instruction to facilitate self-hypnosis has become an established part of our therapeutic regime.
Conclusion: Hypnosis offers many possibilities to facilitate and enhance patient care in neurosurgical departments. Moreover, for specific neurosurgical diseases, such as subarachnoid hemorrhage and spinal cord injury, preliminary findings suggest that hypnosis has therapeutic potential.
