Calming words from their physicians may be more effective than pills for anxious surgical patients, new research shows.
The findings will be presented at the ANESTHESIOLOGY™ 2015 annual meeting in San Diego.
“The anesthesiologist uses calm, positive words to divert the patient’s attention and help him or her feel more comfortable,” says Emmanuel Boselli, MD, PhD, lead author of the study and a physician anesthesiologist at Édouard Herriot Hospital, Lyons, France, in a news release. “It reflects a change in the way the physician interacts with the patient and takes just a few minutes.”
Researchers used conversational hypnosis, which consists of talking quietly and positively to the patient (eg, “Keep calm and quiet” versus “Please don’t move”) and focusing the patient’s attention on something other than the preparations for surgery and anesthesia procedure.
They compared the results of hypnosis to the use of a standard medication called hydroxyzine, which is taken orally to relax patients before their procedure. To measure the effects of both, they asked patients to provide a subjective measurement of their comfort on a scale ranging from 0 (no comfort) to 10 (maximal comfort), as well as used an objective test called the Analgesia/Nociception Index (ANI), a 100-point index that is based on heart rate variability. When patients are extremely anxious and stressed, the ANI is zero, and when they are completely relaxed, the ANI is 100.
In the study of 100 patients undergoing hand surgery, 50 had conversational hypnosis while being given regional anesthesia, and 50 were given 25 mg of oral hydroxyzine 30 minutes to an hour before the induction of anesthesia. Their levels of relaxation were assessed using the ANI as well as the comfort scale, both prior to and after receiving hypnosis or medication and anesthesia.
Patients measured an average ANI of 51 before and 78 after hypnosis, whereas those who had medication averaged 63 before and 70 after. The average comfort scale of those who had received hypnosis was 6.7 before and 9.3 after, while patients who had medication averaged 7.8 before and 8.3 after.
“Conversational hypnosis can be used prior to surgery in conscious patients having local or regional anesthesia,” Boselli says. “It also could be beneficial before general anesthesia to decrease patient anxiety.”
I am glad this is being published. But this is certainly nothing new but we may have all forgotten as physicians what our responsibilities and duties are. One of the most sacred duties we have as physicians is to comfort the patient, using our words, actions, and behavior. But with the “advancement of technology”, we seem to have forgotten this important duty. Along the same vein, we have forgotten that “food is medicine”, and we are all too quickly to prescribe rather than finding out what is going on with the patient….