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AMBULATORY ANESTHESIA

Tape-Recorded Hypnosis Instructions as Adjuvant in the Care of Patients Scheduled for Third Molar Surgery

Mohamed M. Ghoneim, MD^*, Robert I. Block, PhD^*, Daniel S. Sarasin, DDS, Charles S. Davis, PhD, and James N. Marchman, PhD^§

Departments of *Anesthesia, Oral and Maxillofacial Surgery, Preventive Medicine, and §Psychology, The University of Iowa, Iowa City, Iowa

Address correspondence and reprint requests to M. M. Ghoneim, MD, The University of Iowa Hospitals and Clinics, The Department of Anesthesia, 200 Hawkins Dr., 6 JCP, Iowa City, IA 52242.

As medical costs continue to escalate, there is willingness to consider the role played by nontraditional factors in health. We investigated the usefulness of tape-recorded hypnosis instruction on perioperative outcome in surgical patients in a prospective, randomized, and partially blinded study. Sixty patients scheduled for third molar surgery were studied. Patients were allocated to either an experimental group (E) or a control group (C). Group E received an audio tape to listen to daily for the immediate preoperative week, which guided the patients through a hypnotic induction and included suggestions on enhancement of perioperative well-being. Group C did not receive any tapes. The same surgeon administered local anesthesia and a standard regimen of sedation and performed the operation for all patients. The following variables were assessed 1 wk before surgery, immediately before and after surgery, and for 3 days after surgery by the indicated measurements: State anxiety by a Spielberger scale; nausea and pain by visual analog scales; number of tablets of the analgesics that were used; number of episodes of vomiting; and complications. In addition, the surgeon’s assessment of ease of surgery was recorded. Two variables showed differences between the groups. First, Group C exhibited a mean increase of 11.7 points on the Spielberger scale from the screening to the presurgery period, while Group E showed only a mean increase of 5.5 points during the same period, P = 0.01. Second, the mean number of vomiting episodes was more in Group E, 1.3, than in Group C, 0.3, P = 0.02. In conclusion, anxiety was reduced before surgery by means of an audio tape containing hypnotic instructions; however, for no apparent reason, there was also an increase in the incidence of vomiting.

Implications: We administered hypnosis instructions to patients before third molar surgery. Anxiety was reduced, but there was an increase in the incidence of vomiting. Although an easy and cost-effective method, the value of this approach remains to be established.

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				G. H. Montgomery, D. David, G. Winkel, J. H. Silverstein, and D. H. Bovbjerg The Effectiveness of Adjunctive Hypnosis with Surgical Patients: A Meta-Analysis Anesth. Analg., June 1, 2002; 94(6): 1639 - 1645. [Abstract] [Full Text] [PDF]