This is a report to share the experience of managing a patient planned for surgical wound procedure under anaesthesia with medical hypnosis as a tool for sedation and pain relief with a wrist block to supplement the analgesic effect. This was a patient who presented with severe preoperative anxiety and pain concerning her surgical procedure. She developed an allergy to some analgesia from her first surgical procedure. Adequate motivational interviewing techniques with the patient enabled issues about her anxiety to be explored and helped to ease the patient's anxiety. The surgical procedure was successfully done with hypnosis and regional anaesthesia. The patient's response towards pain and anxiety was documented based on Numerical Reporting Scale. The patient's wound care in the ward and clinic proved to be less painful and more comfortable for the patient with her self-hypnosis skill. Empowering the patient with medical hypnosis during the procedure is an option that should be explored.
Hypnosis

During hypnosis patients sometimes fantasize entire complex scenarios and later define these experiences as memories of actual events rather than as imaginings. This article examines 2 cases reporting past-life identity during hypnotic trance state. In each case, elicitation of the past-life events is associated with social constructions, hypnotic procedures and structured interviews which provide demands for the requisite experiences, and which then legitimate the experiences as past-life identities. These 2 cases show their own idiopathic psychodynamics symbolically through past-life regression during hypnosis. This article supports the hypothesis that recall is reconstructive and organized in terms of current expectations and beliefs.
Humans ; Hypnosis*

This case series involving two patients highlights clinical hypnosis as an effective adjunct in anaesthesia for cataract surgery. The first patient was a 55-year old lady, with the American Society of Anaesthesiologists (ASA) classification 2, who was scheduled for cataract surgery for her left eye. The second patient was a 34-year old man, ASA 2, with an underlying retroviral disease, hypertension and a prolapsed intervertebral disc with spinal stenosis of the 3rd to 7th cervical vertebrae, and he was scheduled for cataract surgery in his right eye. These patients were anxious and they responded positively to the proposal of utilising clinical hypnosis as a mode of sedation (hypnosedation) for surgery. Hypnotic induction was achieved with an ideo-dynamic induction, which was described as a non-ritualistic method of hypnosis. Both reported that they experienced profound relaxation during the procedure and were able to respond to the surgical team during the surgery.
Hypnosis, Anesthetic

*Asthma ; *Hypnosis ; *Adolescent ; *Child

No abstract available.
Hypnosis ; Irritable Bowel Syndrome

BACKGROUND: Propofol and remifentanil are usually co-administered and have shown synergistic effect for anesthesia. However, the synergistic effect of the two drugs on hypnosis measured by bispectral index (BIS) was controversial in previous studies. The aim of this study was to identify the interaction of propofol and remifentanil on BIS and the optimal dose combinations for hypnosis under 66% N2O during surgery. METHODS: Patients (age 55-75 and American Society of Anesthesiologists [ASA] 1-2) undergoing gastrectomy were enrolled in this study. Propofol and remifentanil were co-administered incrementally at 1 : 1 potent ratio (the P1R1 group), at 1 : 2 potent ratio (the P1R2 group), or at 2 : 1 potent ratio (the P2R1 group) using effect site target-controlled infusion and BIS was measured. 66% N2O was concomitantly administered to all groups. The dose-effect curves, the 90% effective dose (EC90) for adequate hypnosis (BIS 40), isobolograms and combination index were obtained by Calcusyn program (Biosoft) to reveal the interaction of propofol and remifentanil. RESULTS: The P2R1 group showed synergistic action on BIS. However, the other groups needed larger amount of each drug than the doses of additive action. The EC90 of the P2R1 group was propofol, 3.34 microg/ml and remifentanil, 2.41 ng/ml under 66% of N2O. CONCLUSIONS: Propofol dominant co-administration is needed for dose reduction in BIS guided hypnosis.
Anesthesia ; Gastrectomy ; Humans ; Hypnosis ; Piperidines ; Propofol

Two chronic insomnia cases are presented to illustrate the clinical application of hypnotic techniques. The treatment procedures, which incorporate the demand characteristics of the therapeutic setting, positive expectancies, a reduction in physiological arousal, and a reduction of excessive cognitive activity are discussed.
Arousal ; Hypnosis ; Sleep Initiation and Maintenance Disorders

Patient management is considered an important factor in dental field. The aim of this review is to analyze the efficacy of hypnosis to treat fear, anxiety, pain, stress of dental patients, and see how it can be adopted in dentistry for improving patient satisfaction. Medline research was carried out to find the use of hypnosis in dentistry and other aspects of hypnosis in medical area. It can help patient more comfortable, relax, and accordingly reduce patient's negative feelings such as fear, anxiety, pain, stress during dental treatment. Also, it affects patient recovery after surgery by accelerating healing speed and reinforce immune system. When hypnosis is used with other anesthetic method, it can reduce the use of main medication, leading to reduce possibility of side effect. Therefore, using Hypnosis can give patients more comfortable dental experience, both mentally and physically, ultimately making patients more satisfied with the dental treatment.
Anxiety ; Dentistry* ; Humans ; Hypnosis* ; Immune System ; Methods ; Patient Satisfaction*

The mechanism by which propofol exerts its action is poorly understood, but may involve a non-specific effect on lipid membrane and has been shown to potentiate GABA-mediated synaptic inhibition. And, midazolam also acts through GABA receptor mediated increased chloride conductance. The aim of this study was to evaluate the dose response of midazolam, propofol and combination of these drugs, and determine possible interaction between two drugs in patients. The effect of propofol on the dose response curve for midazolam was studied in 260 nonpremedicated ASA physical status I or II female patients who were scheduled for elective operation. The response to the verbal command was used as an end-point of hypnosis. Dose response curves for midazolam, propofol, and their type of interaction was determined using Instat software package, nonlinear regression analysis, and algebraic(fractional) analysis of interaction. ED of midazolam and propofol was 0.11 mg/kg, 1.13 mg/kg and ED95 was 0.18 mg/kg, 1.67 mg/kg respectively. ED50 of combined drug(midazolam+propofol) in comhined dose response curve was 29% of each drug and the type of interaction between two drugs was found to be synergistic.
Anesthesia* ; Female ; Humans ; Hypnosis ; Membranes ; Midazolam* ; Propofol* ; Receptors, GABA

There was a report that midazolam-thiopental coinduction reduced ED99 of thiopental for hypnosis from 5.75 mg to 2.37 mg. This study was designed to test whether the former study can be used clinically and to compare midazolam-thiopental coinduction with thiopental or midazolam induction. After 120 patients of ASA calss I, II classified into 3 groups randomly, 5.75 mg/kg of thiopental was injected intravenously to each patient for Group I while 0.23 mg/kg of midazolam was injected intravenously to each patient for Group II. For Group III, 2.37 mg/kg of thiopental was injected intravenously to each patient one minute after 0.02 mg/kg of midazolam was injected. Induction rate, induction time, and the changes of cardiovascular response for each group have been compared and the results are as follows: 1) Induction rate was 100%, 75%, 75% for each group. 2) Time for the spontaneous eye closure and loss of the eyelid reflex for Group I were 12.2+/-8.0 seconds, 20.36.9 seconds respectively, while for Group II 51.5+/-26.5 seconds, 69.3+/-29.5 seconds, and for Group III, 25.3+/-7.4 seconds, 37.0+/-10.8 seconds (G. I< G. III < G. II). 3) However, heart rate was relatively higher in Group I at the point of induction but there were no significant differences between groups statistically. 4) It was also impossible to prove that the changes of blood pressure were more stable in one group than others statistically. By judging from the results above, midazolam-pentothal coinduction can be a useful means of induction but coinduction is not superior to thiopental or midazolam induction.
Blood Pressure ; Eyelids ; Heart Rate ; Humans ; Hypnosis ; Midazolam* ; Reflex ; Thiopental*