Hypnosis in surgery

Imagine going through surgery without anaesthesia. You are perfectly calm and feel no pain during the procedure. That’s the possibility offered by hypnotherapy.

Hypnosis has a long history of involvement with surgery. It was first used by a number of surgeons around the same time the first anaesthetic was being discovered in the early 19th century.

Hypnosis in surgery

Before modern anaesthesia, surgery was a gruesome affair – doctors tried to alleviate their patient’s pain through alcohol, opium and blows to the jaw, to little effect.

With the development of ether and other anaesthetics, hypnosis was sidelined.

However, in the last few years, there has been a resurgence of interest in using hypnosis alongside modern anaesthetics, especially in Malaysia.

“Clinical hypnosis is not completely new here. It was started in Tanjung Rambutan (now Hospital Bahagia, Perak) by psychiatrist Tan Sri Dr M. Mahadevan, but the foucs was on mainstream psychiatric care,” says Sheila Menon, principal of London College Of Clinical Hypnosis (LCCH) Asia.

In the 1950s, the British Medical Association, Canadian Medical Association and the American Medical Association all endorsed clinical hypnosis for small scale surgeries and pain management.

“It doesn’t save lives, but it is another tool. Because medicine was focused on saving lives and inventing new life-saving techniques, clinical hypnosis went to the backburner until Dr Abdul Hanan Soh decided to revisit the use of clinical hypnosis in pain management,” adds Sheila.

Dr Abdul Hanan served as a registrar in the department of surgery in multiple government hospitals before opening his own private general practice. While seeing patients, he developed an interest in psychology and acquired skills in hypnosis and counselling psychology.

“I’m more interested in your social background, for example, the circumstances that are contributing to the chronic headache you’re having. Dishing out painkillers is just too superficial,” says Dr Abdul Hanan, who is also the medical director of LCCH Asia.

Hypnosis is effective when used adjunctively with conscious sedation techniques (where the patient is not made unconscious but is only lightly sedated), or it can be used prior to a general anaesthetic to reduce stress and anxiety.

Managing chronic pain

Dr Abdul Hanan’s first project to reduce chronic pain from brachial plexus injury was carried out in Universiti Malaya from 2008 to 2010.

The brachial plexus is a network of nerves that sends signals from your spine to your shoulder, arm and hand.

An injury occurs when these nerves are stretched, compressed, or in the most serious cases, ripped apart or torn away from the spinal cord.

He explains: “The nerve sends pain signals to the brain, which the brain finds unbearable. These patients suffer from constant pain and “electrical” sensations, the intensity varies, and they cannot sleep. Even when they sleep, they are aware of the pain.

“Patients often tell us to just ‘cut the hand off’. Medications are not helpful. Doctors are at a loss about how to deal with this.”

“There is a lot of psychology that goes with the pain. A huge part of it is the belief that ‘I’m now incapacitated, so I’m useless.’ You play your life out according to this belief.”

Clinical hypnosis is a tool to relax you and sort out social difficulties. It can reduce the perception of pain so you’re not suffering.

Sheila adds, “The firing in that part of the brain can be reduced or switched off to reduce sensation.”

The project recruited around 50 patients, and 20 patients completed the course of therapy over the two year period. They all found relief.

Next, in 2014, Dr Abdul Hanan moved on to explore the use of clinical hypnosis in surgery and applied it on patients with carpal tunnel syndrome – a condition that causes pain, numbness, and tingling in the hand and arm. Surgery is a quick 10- to 20-minute procedure to relief pressure on the nerves.

He came up with a four, two-hour session protocol and approached 40 patients; eight agreed, four completed the training, but only two were successful.

“The option was given that if the pain was unbearable, lift their finger to reconfirm if they want anaesthesia, and we will administer it. The anaesthetist was always on standby,” he says.

Since then, hypnosis has been used here in carpel tunnel surgery, inguinal hernia and breast biopsies.

Can anyone be hypnotised?

Although these procedures are new in Malaysia, they have been used successfully overseas, with over 14,000 such cases recorded worldwide.

Research suggests that healing, blood loss, pain medication, general anaesthetics and scarring are significantly reduced when clinical hypnosis is included as part of the pre-operation preparation.

It also shortens the duration of hospital stay and saves cost.

Dr Abdul Hanan says, “If you’re going to compare hypnotic anaesthesia with chemical anaesthesia, the latter wins hands down because you have the assurance that it will work. In hypnotic anaesthesia, it is patient dependent – it may or may not work.

“However, instead of general anaesthesia, we can use local anaesthesia but with hypnosis as sedation. The ability to utilise hypnosis to generate anaesthesia is purely with the patient. I do not induce anaesthesia on the patient. He just follows my voice and induces it using the power of his own mind.”

Naturally, there is a certain discomfort and fear among patients going for any procedure. Personalities that are calm and curious often fare better than “drama queens” who are unable to tolerate pain.

“I train you to disassociate your mind to focus, and when you are aware, shift back away from surgery to your mindfulness. The successful ones tell you they are aware there is pain, but it is bearable.

“Nothing in the hospital protocol sets you up for a more enhancing and positive mind set, and this is when we come in. If you can go to sleep, you can be hypnotised. It’s whether you want to allow yourself to be hypnotised. The hypnotic state is sleeping with an awareness of something that is going on outside you,” he says.

According to Sheila, the state of hypnosis and state of meditation are not physiologically different.

She says: “It’s what we’re doing inside that’s different. With meditation, we’re quietening the busy mind. In hypnosis, we don’t need to do that, whatever the mind is going to do, it is going to do; so the process in the mind is a bit different.”
Read more at http://www.star2.com/health/mind/2016/10/30/hypnosis-in-surgery/#tBTG5E0BGX8jGTRC.99

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