Hypnosis reduces preoperative anxiety in adult patients.

In this study we examined the effect of hypnosis on preoperative anxiety. Subjects were randomized into 3 groups, a hypnosis group (n = 26) who received suggestions of well-being; an attention-control group (n = 26) who received attentive listening and support without any specific hypnotic suggestions and a "standard of care" control group (n = 24). Anxiety was measured pre- and postintervention as well as on entrance to the operating rooms. We found that patients in the hypnosis group were significantly less anxious postintervention as compared with patients in the attention-control group and the control group (31 +/- 8 versus 37 +/- 9 versus 41 +/- 11, analysis of variance, P = 0.008). Moreover, on entrance to the operating rooms, the hypnosis group reported a significant decrease of 56% in their anxiety level whereas the attention-control group reported an increase of 10% in anxiety and the control group reported an increase of 47% in their anxiety (P = 0.001). In conclusion, we found that hypnosis significantly alleviates preoperative anxiety. Future studies are indicated to examine the effects of preoperative hypnosis on postoperative outcomes.

Hemispheric synchronized sounds and intraoperative anesthetic requirements.

Hemispheric synchronization is currently promoted as a treatment for preoperative anxiety and for reduction of intraoperative anesthetic and analgesic consumption. We designed this study to examine the effect of Hemisync sounds on anesthetic hypnotic depth. After obtaining informed consent, we randomized subjects undergoing general anesthesia and outpatient surgery into two groups: the treatment group received Hemisync sounds (n = 31), and the control group received a blank cassette tape (n = 29). Both groups received the intervention in the preoperative area and during the surgical procedure. Subjects underwent a propofol-based anesthetic regimen, and propofol doses required for the induction and maintenance of anesthesia were recorded. A bispectral index monitor was used to ensure that the hypnotic component of the anesthetic state was the same in all patients. We found no differences in the amount of propofol used during the induction of anesthesia (2.49 +/- 0.59 mg/kg versus 2.60 +/- 0.59 mg/kg; P = 0.48) or the maintenance of anesthesia (0.141 +/- 0.02 mg x kg(-1) x min(-1) versus 0.146 +/- 0.04 mg x kg(-1) x min(-1); P = 0.62) between the Hemisync and control groups. We also found no differences between the Hemisync group and the control group for participants with high state anxiety (P = not significant). We conclude that Hemisync sounds do not reduce the hypnotic component of the anesthetic state of patients undergoing general anesthesia and surgery.

Propofol: a new treatment strategy for refractory migraine headache.

Migraine headache remains a treatment dilemma in headache clinics, pain clinics, and emergency departments throughout the country. In the late nineties, investigators reported that a standard hypnotic anesthetic, propofol (2,6 di-isopropylphenol), dramatically improved pain scores of patients suffering from refractory migraine headaches. Case reports over the last few years have appeared in the medical literature describing the use of propofol for migraine treatment. Dosing regimens are not clear, and mechanisms of action to terminate or markedly curtail ongoing intractable headaches are not described. This case report, of two hospitalized patients with refractory migraine, increases the existing literature on the use of propofol therapy in migraine headache. In the first case, three different scenarios and dosages are described in the same patient. In the second case, the use of different dosages of propofol is described. A self-reported scale was employed by the patients to determine the efficacy of propofol therapy. In the first case, the patient's self-reported migraine score was an average of 100/100 and decreased to 10/100. In the second case, the patient's self-reported migraine score improved from 92/100 to 40/100. We propose that the improvements in the self-reported migraine score in both patients after propofol therapy may be due to GABAA agonist effects and cerebral vasoconstriction.