Lynette Bear, RN, DNP, CRNA, a nurse anesthetist at the Laser Spine Institute in Wayne, Pa., understands many patients dont enjoy how they feel when waking up after surgery.
So, Bear supports harnessing the power of positive suggestion to minimize patients postoperative discomfort and the amount of time patients need in postoperative recovery.
“Ive used this for years on many of my patients,” said Bear, a member of the National Guild of Hypnotists and an adjunct faculty member for the Rush University College of Nursing in Chicago in the DNP program, working with students over the Internet. “And so many times, Id get asked by other nurses, ‘Why do your patients always wake up better?”
Hypnosis is not commonly incorporated into anesthesia for surgery in American hospitals or outpatient surgical centers, said Kenneth Y. Pauker, MD, immediate past president of the California Society of Anesthesiologists, attending anesthesiologist at Saddleback Memorial Medical Center in Laguna Hills, Calif., and a member of the communications committee of the American Society of Anesthesiologists.
While formal hypnosis is “used rarely,” Pauker said, “some hypnoidal techniques, meaning the choice of language and tone in communicating with patients, including positive suggestions and/or guided imagery during anesthetic induction, may be employed perhaps a bit more often.
“I cannot imagine that the ASA would object to the use of hypnosis to reduce patient discomfort, so long as it did not interfere with or obstruct the conduct of an anesthetic,” Pauker said.
Bear said a research study she conducted in 2011 in support of her as-yet-unpublished doctoral dissertation at Rush University demonstrated hypnosis led to “significant improvement” in patient comfort levels after surgeries at Laser Spine Institute.
In her formal change study, patients listened to an identical loop audio recording with soothing, positive language during the surgical procedure while under deep sedation. The recording included techniques such as progressive relaxation, guided imagery and instructions for communication if the patient felt any discomfort during the surgery.
After surgery, according to Bears research, just two of the 130 patients who agreed to listen to the loop audio recording suffered postoperative nausea and vomiting, while four of the 123 who did not listen to the audio recording suffered from PONV. And all patients spent almost 12% less time in recovery than patients undergoing similar surgeries who did not listen to the recording, Bear said.
She said less time in recovery would reduce the burden on nurses and cut down on overtime.
Further, she said, four patients in the study who agreed to hypnosis were having surgeries similar to ones they had before. Those patients required half of the anesthetic drugs used in their previous surgeries.
Bear said she believes anesthesia and hypnosis represent a “perfect marriage,” and she hopes more of the healthcare community opens to the use of hypnosis to increase patient comfort. At the Laser Spine Institute, a recording Bear made called “Freedom From Stress” is offered to patients in the preop and the recovery rooms. The institute also gives patients the option of listening to the tape Bear used in her study during surgery.
But even if others might not be as fully onboard as Bear, both Pauker — who co-authored an article about the use of hypnoidal techniques in the April 2012 ASA Newsletter — and Bear said they believe patients could benefit simply from the incorporation of certain techniques incorporating positive suggestion.
For instance, rather than asking patients about their pain levels, nurses can alter their word choices to focus on patient comfort.
“Im hoping that we can begin teaching nurses that even the way we talk to people is important,” Bear said. “This isnt a one-sided thing. People are really into what we can do to help them feel better.”
Jonathan Bilyk is a freelance writer.