Special in-services are needed for members of the surgical team,
who must be taught about the enhanced coordination these cases
demand. The team works alongside and communicates constantly
with the hypnotherapist, who remains by the patient's side for the
entire procedure. Anesthesia providers, in particular, work closely
with the hypnotherapist and the surgical team to titrate local anesthet-
ics — appropriate dosages of local are calculated before procedures
begin and on hand in the room, ready for administration — at the sur-
gical site based on the patient's level of hypnosis.
Consider the benefits
Patients could undergo hypnosedation to eliminate the common side
effects associated with general anesthesia, avoid intubation so as to
not exacerbate severe TMJ disorders or sidestep worries about the
link between inhalational gases and post-op cognitive dysfunction.
Hypnotized patients require no benzodiazepines, volatile anesthetics or
propofol for cases that would otherwise require the administration of
all 3 medications. Plus, the OR is an appropriate setting to attempt hyp-
nosedation for patients who express interest in the technique because
you can easily transition to administering general anesthesia if patients
don't respond appropriately.
We've used electroencephalogram monitoring to measure brain activ-
ity in hypnotized patients and noticed increased activity in the occipital
cortex, which is associated with vision, and decreased activity in some
of the somatosensory pathways, which are associated with pain sensa-
tions. Those fascinating results, which we published in the May 2019
issue of the journal Breast (osmag.net/b9QAuY), provide evidence of
hypnosedation's effectiveness and show it's a method worthy of further
investigation.
After surgery, recovering patients are wide awake and ready for
Anesthesia Alert
AA
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