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

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

OBJECTIVE: To observe the effect of hypnosis on pain and fear in the healthy acupuncture subjects. METHODS: A total of 52 healthy subjects were randomized into an observation group and a control group, 26 cases in each one. In the observation group, the subjects received the first-time acupuncture under hypnosis. After wakened up and 30 min later, the subjects received the second-time acupuncture under clear consciousness condition. In the control group, the subjects received the first-time acupuncture under clear consciousness condition, 30 min later, received the second-time acupuncture under hypnosis. Likert scale was adopted to investigate the relaxation, pain sensation and the willingness in the subjects at the normal condition before acupuncture, after the first-time and the second-time acupuncture of the two groups separately. Using Boeran electronic blood pressure monitor, the pulse and blood pressure were measured in the subjects at the normal condition and after the first-time acupuncture of the two groups. RESULTS: Compared with the normal condition, the relaxation degree was increased, the pain sensation decreased and the willingness enhanced after acupuncture either after hypnosis or after wakened-up in the observation group (<0.001). The difference was not significant in each index between acupuncture after hypnosis and acupuncture after wakened-up in the observation group (>0.05). In the control group, compared with the normal condition, after the first-time acupuncture (acupuncture in clear consciousness), the relaxation degree was decreased, pain was alleviated and the willingness was increased when acupuncture was exerted once again (<0.001, <0.05); compared with the normal condition, after the second-time acupuncture (acupuncture after hypnosis), pain was alleviated and the willingness increased (<0.001), but the difference in relaxation was not significant (>0.05); compared with the first-time acupuncture, the relaxation degree was increased, pain alleviated and willingness enhanced after the second-time acupuncture (acupuncture after hypnosis) (<0.05, <0.001). Compared with the control group after the first-time acupuncture (acupuncture in clear consciousness), the relaxation degree and willingness were increased and the pain sensation was reduced in the observation group during acupuncture either after hypnosis or after wakened-up (<0.001). Compared with the control group the second-time acupuncture (during acupuncture after hypnosis), the relaxation degree was increased and pain sensation reduced in the observation group during acupuncture either after hypnosis or after wakened-up (<0.01, <0.001), but the difference was not significant in willingness (>0.05). In the control group, compared with the normal condition, the pulse was faster, both the diastolic pressure and systolic pressure were increased after the first-time acupuncture (<0.05, <0.01). In the observation group, compared with the normal condition, the pulse was getting slow and blood pressure was reduced after the first-time (acupuncture under hypnosis, <0.01). Compared with the first-time acupuncture in the control group, pulse was getting slow and blood pressure was reduced in the observation group after acupuncture under hypnosis (<0.001). CONCLUSION During acupuncture, with hypnosis combined, the fear alleviates, pain reduces and the willingness of acupuncture increases in the subjects.
Acupuncture Therapy ; Fear ; Humans ; Hypnosis ; Pain ; Pain Management

Previous studies have shown that spinosin was implicated in the modulation of sedation and hypnosis, while its effects on learning and memory deficits were rarely reported. The aim of this study is to investigate the effects of spinosin on the improvement of cognitive impairment in model mice with Alzheimer’s disease (AD) induced by Aβ1–42 and determine the underlying mechanism. Spontaneous locomotion assessment and Morris water maze test were performed to investigate the impact of spinosin on behavioral activities, and the pathological changes were assayed by biochemical analyses and histological assay. After 7 days of intracerebroventricular (ICV) administration of spinosin (100 µg/kg/day), the cognitive impairment of mice induced by Aβ1–42 was significantly attenuated. Moreover, spinosin treatment effectively decreased the level of malondialdehyde (MDA) and Aβ1–42 accumulation in hippocampus. Aβ1–42 induced alterations in the expression of brain derived neurotrophic factor (BDNF) and B-cell lymphoma-2 (Bcl-2), as well as inflammatory response in brain were also reversed by spinosin treatment. These results indicated that the ameliorating effect of spinosin on cognitive impairment might be mediated through the regulation of oxidative stress, inflammatory process, apoptotic program and neurotrophic factor expression, suggesting that spinosin might be beneficial to treat learning and memory deficits in patients with AD via multi-targets.
Alzheimer Disease* ; Animals ; B-Lymphocytes ; Brain ; Brain-Derived Neurotrophic Factor ; Cognition Disorders ; Hippocampus ; Humans ; Hypnosis ; Learning* ; Locomotion ; Malondialdehyde ; Memory Disorders ; Memory* ; Mice* ; Neuroprotection ; Neuroprotective Agents* ; Oxidative Stress ; Water

Anesthetic agent propofol needs to be administered at an appropriate rate to prevent hypotension and postoperative adverse reactions. To comprehend more suitable anesthetic drug rate during surgery is a crucial aspect. The main objective of this proposal is to design robust automated control system that work effi ciently in most of the patients with smooth BIS and minimum variations of propofol during surgery to avoid adverse post reactions and instability of anesthetic parameters. And also, to design advanced computer control system that improves the health of patient with short recovery time and less clinical expenditures. Unlike existing research work, this system administrates propofol as a hypnotic drug to regulate BIS, with fast bolus infusion in induction phase and slow continuous infusion in maintenance phase of anesthesia. The novelty of the paper lies in possibility to simplify the drug sensitivity-based adaption with infusion delay approach to achieve closedloop control of hypnosis during surgery. Proposed work uses a brain concentration as a feedback signal in place of the BIS signal. Regression model based estimated sensitivity parameters are used for adaption to avoid BIS signal based frequent adaption procedure and large off set error. Adaptive smith predictor with lead–lag fi lter approach is applied on 22 diff erent patients' model identifi ed by actual clinical data. The actual BIS and propofol infusion signals recorded during clinical trials were used to estimate patient's sensitivity parameters EC50 and λ. Simulation results indicate that patient's drug sensitivity parameters based adaptive strategy facilitates optimal controller performance in most of the patients. Results are obtained with proposed scheme having less settling time, BIS oscillations and small off set error leads to adequate depth of anesthesia. A comparison with manual control mode and previously reported system shows that proposed system achieves reduction in the total variations of the propofol dose. Proposed adaptive scheme provides better performance with less oscillation in spite of computation delay, surgical stimulations and patient variability. Proposed scheme also provides improvement in robustness and may be suitable for clinical practices.
Anesthesia ; Anesthesia, Intravenous ; Automation ; Brain ; Health Expenditures ; Humans ; Hypnosis ; Hypotension ; Propofol

PURPOSE: This study was conducted to evaluate the effectiveness of autogenic training on stress responses through a systematic review and meta-analysis. METHODS: A systematic search was conducted using eight core electronic databases (Embase, CENTRAL, Medline, CINAHL, PsycInfo, DBpia, KISS, and RISS). To estimate the effect size, a meta-analysis of the studies was performed using RevMan 5.3.5 program. RESULTS: A total 21 studies out of 950 studies were included in the review, and 11 were included for meta-analysis. These studies showed that autogenic training decreased anxiety and depression, and increased the high frequency of heart rate variability. Calculations to understand the effect of autogenic training on anxiety, through a meta-analysis, observed a reduction effect of anxiety score by 1.37 points (n=85, SMD=−1.37: 95% CI −2.07 to −0.67), in the studies on short-term intervention targeting healthy adults. On the other hand, similar calculations to understand the effect of autogenic training on depression observed, a reduction effect on the depression score by 0.29 point (n=327, SMD=−0.29: 95% CI −0.50 to −0.07), in the studies on long term intervention targeting the patient group. CONCLUSION: Autogenic training is effective for adults' stress management, and nurses will be able to effectively perform autogenic training programs for workers' stress relief at the workplace.
Adult ; Anxiety ; Autogenic Training ; Depression ; Hand ; Heart Rate ; Humans ; Stress, Physiological ; Stress, Psychological

No abstract available.
Hypnosis ; Irritable Bowel Syndrome

OBJECTIVESTo evaluate the effects of progressive muscle relaxation training (PMRT) combined with fifive elements music therapy of Chinese medicine (CM) for improving anxiety and depression of cancer patients.

METHODSFrom June 2015 to March 2016, 60 cancer patients were included into the study. The patients were randomly assigned to a control group and a treatment group by envelope randomization, receiving PMRT and PMRT plus CM five elements music therapy, respectively, for 8 weeks. Hospital Anxiety and Depression Scale (HADS), Benefit Finding Scales (BFS), Functional Assessment of Chronic Illness Therapy-Spiritual (FACIT-Sp), and Intervention Expectations Questionnaire (IEQU) were adopted to assess the depression of the two groups before and after the treatment.

RESULTSFour cases dropped out during the study, and 29 cases in the treatment group and 27 in the control group were included in the fifinal analysis. Prior to the treatments, the baselines of the 4 questionnaires in the two groups showed no difference. After the 8-week treatment, the treatment group presented better levels of HADS, BFS and FACIT-Sp scores compared with the control group (P<0.05). Among the single items of HADS, 4 items involving vexation, feeling fifidgeted, pleasure and prospecting the future in the treatment group were improved compared with the control group (P<0.05).

CONCLUSIONSAs a simple and reliable and effective intervention, PMRT combined with fifive elements music therapy mitigated anxiety and depression of cancer patients. Cancer patients have been found to respond well to psychological intervention in areas regarding stabilisation of emotions, disease awareness, and therapeutic compliance. This brings about a great difference in improving their quality of life and psychological state, offers an effective approach to better self-management in cancer treatment.

Autogenic Training ; Demography ; Depression ; therapy ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Music ; Neoplasms ; psychology ; Surveys and Questionnaires

BACKGROUND: Hypnosis monitors analyze small-amplitude electrical signals transmitted from the brain that could be exposed to the electromagnetic field that occurs around the body during electrocautery (ECT). We investigated the influence of ECT on hypnosis monitoring during anesthesia. METHODS: We simultaneously monitored BIS and uCON during 50 gynecologic oncology surgeries. During the episodes of ECT, we compared the absolute difference (a-Diff) between the baseline index and the most deviated index after ECT over either 30–60 s (ECT30–60) or more than 60 s (ECT > 60) between the monitors. We also investigated the bias and the limits of agreement between the monitors. RESULTS: Between the two monitors, the a-Diff of ECT30–60 was 1.4 ± 1.1 for the BIS, which was significantly greater than 0.6 ± 0.9 for the uCON (P = 0.003), and the a-Diff of ECT > 60 was 16.5 ± 8.2 for the BIS, which was also significantly greater than 1.4 ± 1.3 for uCON (P < 0.001). The intra-monitor index differences showed that the BIS during ECT > 60 was significantly greater than that during ECT30–60 (P < 0.001), but the uCON showed no significant difference between ECT30–60 and ECT > 60 (P = 0.056). The estimated bias between the monitors was 6.3 ± 9.8 and 95% limits agreement was –12.3 to 25.0. CONCLUSIONS: Prolonged ECT intervention might lead to spurious estimations of quantitative EEG indexes. Therefore, hypnosis should be clinically assessed in combination with scrutinized judgment of relevant clinical symptoms and signs for hypnosis.
Anesthesia ; Anesthesia, General* ; Bias (Epidemiology) ; Brain ; Electrocoagulation ; Electroencephalography ; Electromagnetic Fields ; Hypnosis* ; Judgment ; Magnets*

Neurologic symptoms that develop unconsciously and are incompatible with known pathophysiologic mechanisms or anatomic pathways belong to Conversion Disorder (CD). CD diagnosis is based on the clinical history and the exclusion of physical disorders causing significant distress or social and occupational impairment. In a subgroup of CD, called functional weakness (FW), symptoms affecting limbs may be persistent, thus causing a permanent or transient loss of limb function. Physiotherapy, pharmacotherapy, hypnotherapy and repetitive transcranial magnetic stimulation (rTMS) have been proposed as treatment strategies for FW-CD. Herein, we report a 30 year-old male, presenting with lower limb functional paraparesis, having obtained positive, objectively, and stable effects from a prolonged r-TMS protocol associated to a multidisciplinary approach, including psychological and sexuological counseling, and monitored by gait analysis. We postulate that our rTMS protocol, combined with a multidisciplinary approach may be the proper treatment strategy to improve FW-CD.
Brain* ; Conversion Disorder ; Counseling ; Diagnosis ; Drug Therapy ; Extremities ; Gait ; Humans ; Hypnosis ; Lower Extremity ; Male ; Neurologic Manifestations ; Paraparesis* ; Transcranial Magnetic Stimulation