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| |  WCA: Hypnosis Demonstrates Role as Adjunct to Anaesthesia in Obstetrics By Jill Stein PARIS, FRANCE -- April 19, 2004 -- Hypnosis and suggestion may be a useful adjunct to an obstetrical anaesthesia practice and reduce the need for anaesthesia during childbirth, according to data presented on April 19th at the 13th World Congress of Anaesthesiologists (WCA). Dr. Allan M. Cyna, Women's and Children's Hospital, Adelaide, Australia, and co-workers reviewed 12 months of clinical experience of two anaesthesiologists who used hypnosis and suggestion as adjuncts to their obstetrical anaesthesia practice. Clinical hypnosis refers to the use of words and gestures in particular ways to achieve specific therapeutic outcomes, such as a change in patient experience or behaviour. Awake-suggestions are therapeutic communications without formal hypnosis. Dr. Cyna noted that their study follows a growing body of evidence in support of a role for hypnosis and suggestion in anaesthetic practice. "For example, controlled clinical trials in surgical and obstetric settings have demonstrated that hypnosis is a useful intervention for managing pain and anxiety [Faymonville et al. Pain. 1997 Dec;73(3):361-7]," he said. "In addition, a well-designed randomised, controlled trial investigating the use of hypnosis during interventional radiology procedures showed a decrease in the requirements of intraoperative sedation and procedure time compare with controls [Lang et al. Int J Clin Exp Hypn. 1996 Apr;44(2):106-119.]." Various case series and case studies have also detailed the routine clinical use of hypnosis by anaesthesiologists for selected patients, he added. Finally, positron emission tomography and electroencephalogram activity show clear evidence of changes in the anterior cingulate gyrus during hypnotic modulation of pain. Dr. Cyna said his study found that 21% of 24 women required only inhalational or no analgesia during labour and that 92% of women said they found antenatal hypnosis preparation to be beneficial to their childbirth experience. Results also show that 5 of 6 patients (83%) who were resistant to pharmacologic therapy for hyperemesis gravidarum, showed an improvement in symptoms. Four women who requested epidural analgesia during labour found awake-suggestions effective enough to avoid the need for further analgesia. And hypnosis was helpful in the management of 6 women with severe needle phobia and 2 with severe perioperative anxiety. Dr. Cyna emphasised that awareness of the implications of inadvertent negative suggestions is likely to optimise patients' anaesthetic management. He cautioned that well-designed trials should be conducted to assess the effects of hypnosis and suggestion in obstetrics. References
[Study title: Hypnosis and the use of suggestion in anaesthetic practice. Abstract 130]
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