Hello, is there anybody in there?
Just nod if you can hear me, is there anyone home?
Perhaps the title in the famous Pink Floyd song could be applied to the female patient from whom a thigh tumour was removed solely under hypnotic focused analgesia, as described by Facco et al. in their case report in this month’s issue of Anaesthesia . However, this title could also aptly describe the attitude of many modern anaesthetists towards accommodating unconventional therapies that could be really useful adjuncts in their theatre, labour ward and pain clinics. Unless ideas fall within our limits of understanding, we often have no time or inclination to question, learn about, or use them. Hypnosis and acupuncture are two ‘weird’ phenomena that have been described in the anaesthetic literature for over 150 years, yet there is still reluctance to accept them in some quarters.
As anaesthetists, we have no problem employing a technique whose mechanism of action we do not fully understand at a cellular level since its endpoint (loss of con- sciousness) is clear. Many clinicians reject hypnosis and acupuncture since their mechanism of action is also a mystery but in addition, their endpoint is hard to define. Facco et al. describe a scientific and pragmatic approach to hypnosis that seems so straightforward that some of us might even harbour thoughts of disbelief as to its validity and credibility. The authors have provided good evidence of a measurable endpoint; however, those of us who are not ‘numb’ will want to know more and see more cases ‘live’. There is no increased incidence of anaphylactic reactions to general anaesthetics in patients with the ‘multiple chemical sensitivity’ described in this report , and most of us would probably opt for a straightforward general anaesthetic in such a case. However, substitute this patient for one with severe ischaemic heart disease or perhaps muscular dystrophy, and the hypnosis option might seem of more interest.
Continue reading…… Hypnotic Anaesthesia
© 2013 The Association of Anaesthetists of Great Britain and Ireland