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🚀👉 Healthy Mind strengthens its presence in the United Kingdom with the acquisition of Rescape Innovation 🇬🇧

ask for a demonstration

🚀👉 Healthy Mind strengthens its presence in the United Kingdom with the acquisition of Rescape Innovation 🇬🇧

Hypnosurgery: myth or reality?

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L'hypnosédation, mélange d'hypnose et de sédation, réduit l’anxiété des patients et améliore leur confort à chaque étape de l’intervention.

When medical hypnosis enters the operating room

Hypnosurgery, a combination of hypnosis and sedation, now offers a complement to locoregional anaesthesia and, in some cases, an alternative to general anaesthesia. Beyond reducing patients’ anxiety, it improves their comfort at every stage of the procedure. How does this non-drug technique work and what is its real efficacy on pain? Let us explore.

What is hypnosurgery?

Definition of hypnosis under sedation

Hypnosedation is an anaesthetic method based on three elements:

  • a local anaesthetic that numbs only the operated area;
  • a low-dose intravenous sedation, far below doses used for general anaesthesia, to soothe and lessen pain perception;
  • hypnotic support aimed at inducing a positive trance, that is, a modified state of consciousness, focused and detached from the medical context.

This protocol is generally carried out by an anesthesiologist trained in hypnosis to guarantee patient safety and to be able to convert to general anaesthesia if necessary. Hospitals offering this procedure provide pre-anaesthetic consultations to assess eligibility and to prepare the session under optimal conditions.

A brief history of hypnosis in anaesthesia

Did you know that hypnosis in operating theatres is not a modern invention? As early as 1830, Jules Cloquet and John Elliotson performed surgical procedures under isolated hypnosis. Between 1845 and 1851, the Scottish surgeon in the Indian Army, James Esdaile, also resorted to hypnosis for around 300 surgical patients.

Why was hypnosis later abandoned? Simply because two discoveries ushered in the era of chemical anaesthesia: ether in 1846 and chloroform in 1847. From then on, the practice of hypnosis in surgery faded before chemical anaesthetic agents. Furthermore, Freud’s place in history relegated hypnosis to the toolbox of psychotherapy.

Medical hypnosis remained in the background until 1955, when the British Medical Association declared that there was a place for it in anaesthesia. Since then, hypnosis in the hospital setting has had its ups and downs, ultimately finding its role as a complementary technique, as noted by the French Society of Anaesthesia and Intensive Care (Sfar):

“hypnosis cannot be considered as a technique substituting for general anaesthesia, but rather as an adjuvant to anaesthesia which improves its quality in certain circumstances, in particular for local or locoregional anaesthesia.”

How does hypnosis act on the brain?

Hypnosis alters the way the brain processes sensory and emotional information. Imaging studies and clinical research show modulation of brain networks involved in attention, emotional appraisal and pain perception under hypnosis, particularly the anterior cingulate cortex and areas linked to the processing of pain and emotions.

Two effects of hypnosis therefore overlap:

  • attentional redirection: hypnosis focuses the patient’s attention on a chosen theme (comforting memory, calming visualisation, etc.), reducing cognitive availability to process aversive signals;
  • diminution of the affective component of pain: at the cerebral level, the emotional impact is attenuated, even though sensory detection remains.

The depth of trance, suggestibility and the patient’s cooperation influence the intensity of these outcomes. Hypnosis doesn’t magically eliminate pain, it modifies how pain is experienced and integrated by the brain. Consequently, anxiety decreases, as do intraoperative discomfort and analgesic consumption.

What happens during a medical hypnosis session in surgery?

Hypnosurgery follows a structured protocol designed to ensure safety while facilitating the entry into trance. The typical pathway comprises three key stages:

  • the pre-anaesthetic consultation;
  • preparation and induction in the theatre;
  • intraoperative management and emergence from the hypnotic state.

1. The pre-anaesthetic consultation

The anesthesiologist trained in medical hypnosis assesses the patient’s eligibility according to the type of procedure, medical history and understanding of the process. They then choose the most appropriate hypnotic strategy.

2. Preparation and induction in the theatre

First, standard monitoring is put in place: ECG, oxygen saturation, blood pressure, etc. A drip is started and low-dose intravenous sedation is administered in addition to a local anaesthetic to the area concerned.

Secondly, the anaesthetist guides the hypnotic induction using breathing or music to focus attention and establish a secure dissociative state. During the procedure, pre-agreed cues (a hand signal, a frown, etc.) allow the patient to indicate any discomfort.

3. Intraoperative management and emergence from the hypnotic state

If discomfort occurs, the medical team first addresses it locally (reinjection of local anaesthetic, adjustment of sedation, etc.). Conversion to general anaesthesia remains possible, though it is rare.

At the end of the procedure, the anaesthetist invites the patient to re-orient to the environment and offers positive suggestions for the postoperative period (recovery, sleep, appetite, wound healing, etc.).

Hypnosedation: an option for every patient?

Can all surgical operations be performed with hypnosis as an anesthetic?

Despite its many advantages, hypnosedation isn’t universal. It is mainly suited to superficial or minimally invasive procedures for which a local anaesthetic suffices and where patient cooperation is possible. Examples include surface surgery such as implantation of access ports or pacemakers, varicose vein or hernia surgery, ambulatory procedures, as well as certain urological procedures or endoscopies.

Deep surgeries, long procedures or emergency situations remain the domain of general anaesthesia. The assessment of the method is the responsibility of the anaesthetist-surgeon pair.

Furthermore, the effectiveness of hypnosurgery depends on the patient’s motivation and cooperation. Indeed, the hypnotic state is facilitated when the patient is willing and reassured by the team. If hypnosis cannot be induced or discomfort arises, conversion to general anaesthesia is always possible.

What are the effects of postoperative hypnosis?

Hypnosis used at the end of surgery targets the postoperative experience. Clinical observations regularly report a calmer recovery, less fatigue and a reduction in nausea compared with the usual course following general anaesthesia.

These effects also translate into an emotionally calmer awakening, reduced discomfort with immediate care (noise, manipulations, technical procedures) and a feeling of comfort during the first hours.

This approach also fosters a more harmonious relationship between the patient and the care team, an important factor for the quality of the postoperative experience.

The future of sedation under hypnosis: towards hybrid approaches with virtual reality

While hypnosurgery is primarily based on the relationship between the patient and the practitioner, new approaches are now helping to facilitate hypnotic induction and strengthen the sense of security in the operating room. Among these is the use of immersive virtual reality.

By directing the patient’s attention towards a soothing scenario, VR headsets help to enter a dissociative state more rapidly, as shown by numerous clinical studies to which we contribute.

Designed in collaboration with a rigorous scientific committee, our therapeutic environments offer visual and sound universes specifically conceived for medical relaxation. The scenes are constructed to accompany breathing, reduce emotional load and establish a durable state of calm.

The benefits of combining the Healthy Mind device with hypnosedation include, notably:

  • standardisation of immersion, which facilitates entry into the hypnotic state even in people unfamiliar with the practice;
  • reduction of preoperative anxiety, thanks to content designed for medical contexts and ready-to-use equipment;
  • support for the anaesthetist’s work, who can rely on a stable, coherent environment to guide their hypnotic suggestions;
  • access to an anxiolytic and distracting effect without requiring personnel specifically trained in hypnosis;
  • increased patient engagement through a playful and accessible element.

Dr Christophe Rabuel, anesthesiologist at Lariboisiere Hospital – APHP, testifies:

“The immersive virtual reality solution offered by Healthy Mind has its place in the therapeutic arsenal, notably as a complement to pharmacological sedation techniques […]. The immersive quality of the visual and sound environment, its realism and its personalisation make it a high-quality tool.”

Hypnosurgery is no longer a mere myth: clinical data and feedback from specialised teams show that it’s a reliable and beneficial option. Its combination with immersive tools such as Healthy Mind therapeutic virtual reality opens up broader prospects for access and efficacy. Would you like to see its potential for yourself? Request a demonstration.

 

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