Disbrow E A, Bennett H L, Owings J T
Department of Anesthesiology, University of California, Davis, School of Medicine, Sacramento 95817.
West J Med. 1993 May;158(5):488-92.
Autonomic behavior is subject to direct suggestion. We found that patients undergoing major operations benefit more from instruction than from information and reassurance. We compared the return of intestinal function after intra-abdominal operations in 2 groups of patients: the suggestion group received specific instructions for the early return of gastrointestinal motility, and the control group received an equal-length interview offering reassurance and nonspecific instructions. The suggestion group had a significantly shorter average time to the return of intestinal motility, 2.6 versus 4.1 days. Time to discharge was 6.5 versus 8.1 days. Covariates including duration of operation, amount of intraoperative bowel manipulation, and amount of postoperative narcotics were also examined using the statistical model analysis of covariance. An average savings of $1,200 per patient resulted from this simple 5-minute intervention. In summary, the use of specific physiologically active suggestions given preoperatively in a beleivable manner can reduce the morbidity associated with an intra-abdominal operation by reducing the duration of ileus.
自主行为会受到直接暗示的影响。我们发现，接受大手术的患者从指令中获得的益处比从信息及安慰中更多。我们比较了两组接受腹部手术患者的肠道功能恢复情况：暗示组接受了关于胃肠动力早期恢复的具体指令，而对照组接受了时长相同的访谈，内容包括安慰及非特定指令。暗示组肠道动力恢复的平均时间显著更短，分别为2.6天和4.1天。出院时间分别为6.5天和8.1天。还使用协方差统计模型分析检查了包括手术时长、术中肠道操作量及术后麻醉药量在内的协变量。这种简单的5分钟干预使每位患者平均节省了1200美元。总之，术前以可信的方式给出特定的生理活性暗示，可通过缩短肠梗阻持续时间来降低腹部手术相关的发病率。
