Hypnosis Shown to Reduce Post-Operative Drug Use

In a study of patients undergoing total knee arthroplasty (TKA), those undergoing hypnosis before surgery used fewer opioids postoperatively than their counterparts who did not undergo psychosis, even though pain, length of hospital stay, and complications were similar between the two patient groups.

Results of the randomized controlled study showed patients who receive hypnosis experienced a 24% reduction in postop opioid use vs the non-hypnosis group.

"I'm hoping this intervention gets attention from surgeons and internists, and anesthesiologists as well, as being a viable option for surgical patients [to reduce opioid use]," study investigator Jessie Kittle, MD, Stanford School of Medicine, Stanford, California, told Medscape Medical News.

The findings were presented at the virtual American Academy of Pain Medicine (AAPM) 2021 Annual Meeting.

"I picked a job right out of residency as a surgical pain management hospitalist and would see many people who come in for orthopedic surgery, and it occurred to me that a good 50% of my day was treating opioid-related complications after surgery," said Kittle.

"I was getting consults for low blood pressure, vomiting, constipation that was turning into bowel obstructions, and yet people were also in horrible pain all the time. It occurred to me that there must be other tools that we can use besides opioids," Kittle said.

She began to delve into the literature on treating pain after orthopedic surgery and was surprised to find a wealth of literature on the use of hypnosis for procedural pain and reducing opioid use. "I couldn't believe that I had not heard about this before in medical school or otherwise," she said.

Not everybody is hypnotizable, Kittle said. About 75% of the population can be hypnotized, and this ability remains stable for each person throughout their life span.

"We can test this with functional MRI. If we put people who are not hypnotizable under a memory condition, a hypnosis condition, and a resting state, where they are not thinking about anything, nothing happens. But when you try to hypnotize people who are highly hypnotizable, you see a huge change in the connections between certain parts of the brain," she explained.

SOURCE: Medascape