Ghoneim M M, Block R I, Sarasin D S, Davis C S, Marchman J N
Department of Anesthesia, The University of Iowa, Iowa City 52242, USA.
Anesth Analg. 2000 Jan;90(1):64-8. doi: 10.1097/00000539-200001000-00016.
As medical costs continue to escalate, there is willingness to consider the role played by nontraditional factors in health. We investigated the usefulness of tape-recorded hypnosis instruction on perioperative outcome in surgical patients in a prospective, randomized, and partially blinded study. Sixty patients scheduled for third molar surgery were studied. Patients were allocated to either an experimental group (E) or a control group (C). Group E received an audio tape to listen to daily for the immediate preoperative week, which guided the patients through a hypnotic induction and included suggestions on enhancement of perioperative well-being. Group C did not receive any tapes. The same surgeon administered local anesthesia and a standard regimen of sedation and performed the operation for all patients. The following variables were assessed 1 wk before surgery, immediately before and after surgery, and for 3 days after surgery by the indicated measurements: State anxiety by a Spielberger scale; nausea and pain by visual analog scales; number of tablets of the analgesics that were used; number of episodes of vomiting; and complications. In addition, the surgeon's assessment of ease of surgery was recorded. Two variables showed differences between the groups. First, Group C exhibited a mean increase of 11.7 points on the Spielberger scale from the screening to the presurgery period, while Group E showed only a mean increase of 5.5 points during the same period, P = 0.01. Second, the mean number of vomiting episodes was more in Group E, 1.3, than in Group C, 0.3, P = 0.02. In conclusion, anxiety was reduced before surgery by means of an audio tape containing hypnotic instructions; however, for no apparent reason, there was also an increase in the incidence of vomiting.
We administered hypnosis instructions to patients before third molar surgery. Anxiety was reduced, but there was an increase in the incidence of vomiting. Although an easy and cost-effective method, the value of this approach remains to be established.
随着医疗成本持续攀升，人们愿意考虑非传统因素在健康方面所起的作用。我们在一项前瞻性、随机且部分盲法研究中，调查了录音催眠指导对手术患者围手术期结局的有效性。研究了60例计划进行第三磨牙手术的患者。患者被分为实验组（E）或对照组（C）。E组患者在术前一周每天收听一盘录音带，该录音带引导患者进行催眠诱导，并包含有关增强围手术期幸福感的建议。C组未收到任何录音带。同一位外科医生为所有患者实施局部麻醉和标准镇静方案并进行手术。通过以下指定测量方法在手术前1周、手术前后即刻以及手术后3天评估以下变量：用斯皮尔伯格量表评估状态焦虑；用视觉模拟量表评估恶心和疼痛；使用的镇痛药片数；呕吐发作次数；以及并发症。此外，记录外科医生对手术难易程度的评估。两组之间有两个变量存在差异。首先，C组从筛查到术前阶段在斯皮尔伯格量表上的平均分增加了11.7分，而E组在同一时期仅平均增加了5.5分，P = 0.01。其次，E组呕吐发作的平均次数为1.3次，多于C组的0.3次，P = 0.02。总之，通过包含催眠指导的录音带可在手术前减轻焦虑；然而，原因不明的是，呕吐发生率也有所增加。
我们在第三磨牙手术前对患者进行催眠指导。焦虑减轻了，但呕吐发生率增加了。尽管这是一种简便且经济有效的方法，但其价值仍有待确定。
