ScienceDaily (June 11, 2011) — Using a combination of hypnosis and local anaesthesia (LA) for certain types of surgery can aid the healing process and reduce drug use and time spent in hospital, anaesthesiologists have found. The combination could also help avoid cancer recurrence and metastases, according to new research to be presented at the European Anaesthesiology Congress in Amsterdam.

Professor Fabienne Roelants and Dr. Christine Watremez, from the Department of Anaesthesiology at the Cliniques Universitaires St. Luc, UCL, Brussels, Belgium, studied the impact of using LA and hypnosis in certain kinds of breast cancer surgery and in thyroidectomy (removal of all or part of the thyroid gland). “In all of these procedures local anaesthesia is feasible but not, on its own, sufficient to ensure patient comfort,” says Professor Roelants.

In the first study, 18 women out of 78 had hypnosis for a number of breast cancer surgical procedures — quadrantectomy (partial mastectomy), sentinel node biopsy (examination of the first lymph node or group of lymph nodes likely to be reached by metastasising cancer cells) and axillary dissection (opening the armpit to examine or remove some or all of the lymph nodes) — while the rest had general anaesthetic (GA) or the same operations. Although the patients who were hypnotised spent a few minutes more in the operating theatre, opioid drug use in the first group was greatly diminished, as was time in the recovery room and hospital stay.

In the thyroid study, the researchers compared the outcomes of 18 patients in the LA/hypnosis group with 36 who had GA. Both groups had video-assisted thyroidectomy, in an attempt to decrease the invasiveness of the procedure without reducing patient comfort. Once again drug use, recovery room and hospital stay times were greatly reduced among the LA/hypnosis group.

“In addition to reducing drug use and hospital stay time, being able to avoid general anaesthesia in breast cancer surgery is important because we know that local anaesthesia can block the body’s stress response to surgery and could therefore reduce the possible spread of metastases,” Professor Roelants will say.

“Together with other anaesthesiologists at the hospital, we are specialised in hypnosis,” says Dr. Watremez. “Although there are special precautions to be taken — for example, only the hypnotherapist should talk to the patient during the procedure and should avoid negatives, which unconsciousness cannot handle, and the surgeon needs to be gentle, avoid any tugging in his movements, and be able to remain cool in all circumstances — it is a straightforward procedure and appreciated by the patients.

“Imagine you are driving your car. You suddenly realise how far you have driven, but for a long time your mind has been elsewhere. This is extremely common, and is nothing more nor less than a mild hypnotic trance — a modified state of consciousness, with a different perception of the world. The principle of hypnosis is to focus one’s attention on one particular point,” she says.

That point may be eye fixation, progressive muscle relaxation, or the retrieval of a pleasant memory. That hypnosis works in reducing the perception of pain has been shown by a number of studies, including by imaging the brain with position emission tomography (PET). Similar effects have been shown by using functional magnetic resonance imaging (MRI). Exactly how hypnosis works in this respect is still under discussion. Some researchers believe that it prevents information from reaching the higher cortical regions that are responsible for the perception of pain. Others believe that it permits a better response to pain by activating pain-inhibiting paths more effectively.

“There is still a lot of debate around the exact mechanism that allows hypnosis to reduce pain perception,” says Professor Roelants,” but what it absolutely clear is that it does so. The result is that one third of thyroidectomies and a quarter of all breast cancer surgery carried out at the UCL hospital are performed under local anaesthetic with the patient under hypnosis.”

There are no sex or age differences relating to susceptibility to hypnosis, the researchers say. If the patient is motivated, ready to co-operate, and trusts the doctors, hypnosis will work. In addition to use in breast cancer surgery and thyroidectomy, the practice can be used in a number of other surgical procedures, for example carotid artery surgery, inguinal hernia, knee arthroscopy, gynaecological surgery, ophthalmology, ear nose and throat, plastic surgery and egg retrieval for fertility treatment.

“We believe that our studies have shown considerable benefits for the LA/hypnosis combination, and that such benefits are not only for patients, but also for healthcare systems. By using hypnosis combined with LA we can reduce the costs involved in longer hospital stays, remove the need for patients to use opioid drugs, and increase their overall comfort and satisfaction levels. To date there are few publications about the use of hypnosis in surgery, and we hope that, by contributing to the body of evidence on its efficacity, our research will encourage others to carry out this procedure to the advantage of all concerned,” Dr. Watremez will conclude.

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Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by European Society of Anaesthesiology, via EurekAlert!, a service of AAAS.

---

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

ScienceDaily (June 11, 2011) — Using a combination of hypnosis and local anaesthesia (LA) for certain types of surgery can aid the healing process and reduce drug use and time spent in hospital, anaesthesiologists have found. The combination could also help avoid cancer recurrence and metastases, according to new research to be presented at the European Anaesthesiology Congress in Amsterdam.

Professor Fabienne Roelants and Dr. Christine Watremez, from the Department of Anaesthesiology at the Cliniques Universitaires St. Luc, UCL, Brussels, Belgium, studied the impact of using LA and hypnosis in certain kinds of breast cancer surgery and in thyroidectomy (removal of all or part of the thyroid gland). “In all of these procedures local anaesthesia is feasible but not, on its own, sufficient to ensure patient comfort,” says Professor Roelants.

In the first study, 18 women out of 78 had hypnosis for a number of breast cancer surgical procedures — quadrantectomy (partial mastectomy), sentinel node biopsy (examination of the first lymph node or group of lymph nodes likely to be reached by metastasising cancer cells) and axillary dissection (opening the armpit to examine or remove some or all of the lymph nodes) — while the rest had general anaesthetic (GA) or the same operations. Although the patients who were hypnotised spent a few minutes more in the operating theatre, opioid drug use in the first group was greatly diminished, as was time in the recovery room and hospital stay.

In the thyroid study, the researchers compared the outcomes of 18 patients in the LA/hypnosis group with 36 who had GA. Both groups had video-assisted thyroidectomy, in an attempt to decrease the invasiveness of the procedure without reducing patient comfort. Once again drug use, recovery room and hospital stay times were greatly reduced among the LA/hypnosis group.

“In addition to reducing drug use and hospital stay time, being able to avoid general anaesthesia in breast cancer surgery is important because we know that local anaesthesia can block the body’s stress response to surgery and could therefore reduce the possible spread of metastases,” Professor Roelants will say.

“Together with other anaesthesiologists at the hospital, we are specialised in hypnosis,” says Dr. Watremez. “Although there are special precautions to be taken — for example, only the hypnotherapist should talk to the patient during the procedure and should avoid negatives, which unconsciousness cannot handle, and the surgeon needs to be gentle, avoid any tugging in his movements, and be able to remain cool in all circumstances — it is a straightforward procedure and appreciated by the patients.

“Imagine you are driving your car. You suddenly realise how far you have driven, but for a long time your mind has been elsewhere. This is extremely common, and is nothing more nor less than a mild hypnotic trance — a modified state of consciousness, with a different perception of the world. The principle of hypnosis is to focus one’s attention on one particular point,” she says.

That point may be eye fixation, progressive muscle relaxation, or the retrieval of a pleasant memory. That hypnosis works in reducing the perception of pain has been shown by a number of studies, including by imaging the brain with position emission tomography (PET). Similar effects have been shown by using functional magnetic resonance imaging (MRI). Exactly how hypnosis works in this respect is still under discussion. Some researchers believe that it prevents information from reaching the higher cortical regions that are responsible for the perception of pain. Others believe that it permits a better response to pain by activating pain-inhibiting paths more effectively.

“There is still a lot of debate around the exact mechanism that allows hypnosis to reduce pain perception,” says Professor Roelants,” but what it absolutely clear is that it does so. The result is that one third of thyroidectomies and a quarter of all breast cancer surgery carried out at the UCL hospital are performed under local anaesthetic with the patient under hypnosis.”

There are no sex or age differences relating to susceptibility to hypnosis, the researchers say. If the patient is motivated, ready to co-operate, and trusts the doctors, hypnosis will work. In addition to use in breast cancer surgery and thyroidectomy, the practice can be used in a number of other surgical procedures, for example carotid artery surgery, inguinal hernia, knee arthroscopy, gynaecological surgery, ophthalmology, ear nose and throat, plastic surgery and egg retrieval for fertility treatment.

“We believe that our studies have shown considerable benefits for the LA/hypnosis combination, and that such benefits are not only for patients, but also for healthcare systems. By using hypnosis combined with LA we can reduce the costs involved in longer hospital stays, remove the need for patients to use opioid drugs, and increase their overall comfort and satisfaction levels. To date there are few publications about the use of hypnosis in surgery, and we hope that, by contributing to the body of evidence on its efficacity, our research will encourage others to carry out this procedure to the advantage of all concerned,” Dr. Watremez will conclude.

---

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by European Society of Anaesthesiology, via EurekAlert!, a service of AAAS.

---

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

ScienceDaily (June 10, 2011) — For the first time researchers have been able to watch what happens to the brain as it loses consciousness. Using sophisticated imaging equipment they have constructed a 3-D movie of the brain as it changes while an anaesthetic drug takes effect.

Brian Pollard, Professor of Anaesthesia at The University of Manchester (UK), will tell the European Anaesthesiology Congress in Amsterdam that the real-time 3-D images seemed to show that losing consciousness involves a change in electrical activity deep within the brain, changing the activity of certain groups of nerve cells (neurons) and hindering communication between different parts of the brain.

He said the findings appear to support a hypothesis put forward by Professor Susan Greenfield, of the University of Oxford, about the nature of consciousness itself. Prof Greenfield suggests consciousness is formed by different groups of brain cells (neural assemblies), which work efficiently together, or not, depending on the available sensory stimulations, and that consciousness is not an all-or-none state but more like a dimmer switch, changing according to growth, mood or drugs. When someone is anaesthetised it appears that small neural assemblies either work less well together or inhibit communication with other neural assemblies.

“Our findings suggest that unconsciousness may be the increase of inhibitory assemblies across the brain’s cortex. These findings lend support to Greenfield’s hypothesis of neural assemblies forming consciousness,” said Prof Pollard.

The team use an entirely new imaging method called “functional electrical impedance tomography by evoked response” (fEITER*), which enables high speed imaging and monitoring of electrical activity deep within the brain and is designed to enable researchers to measure brain function.

The new device was developed by a multidisciplinary team drawn from the Schools of Medicine and Electrical and Electronic Engineering at The University of Manchester (UK) led by Professor Hugh McCann and with support from a Wellcome Trust Translation Award.

The machine itself is a portable, light-weight monitor, which can fit on a small trolley. It has 32 electrodes that are fitted around the patient’s head. A small, high-frequency electric current (too small to be felt or have any effect) is passed between two of the electrodes, and the voltages between other pairs of electrodes are measured in a process that takes less than one thousandth of a second.

An “electronic scan” is thus carried out and the machine does this whole procedure 100 times a second. By measuring the resistance to current flow (electrical impedance), a cross sectional image of the changing electrical conductivity within the brain is constructed. This is thought to reflect the amount of electrical activity in different parts of the brain. The speed of the response of fEITER is such that the evoked response of the brain to external stimuli, such as an anaesthetic drug, can be captured in rapid succession as different parts of the brain respond, thus tracking the brain’s processing activity.

“We have looked at 20 healthy volunteers and are now looking at 20 anaesthetised patients scheduled for surgery,” said Prof Pollard. “We are able to see 3-D images of the brain’s conductivity change, and those where the patient is becoming anaesthetised are most interesting.”

“We have been able to see a real time loss of consciousness in anatomically distinct regions of the brain for the first time. We are currently working on trying to interpret the changes that we have observed. We still do not know exactly what happens within the brain as unconsciousness occurs, but this is another step in the direction of understanding the brain and its functions.”

The team at Manchester is one of many worldwide teams investigating electrical impedance tomography (EIT), but this is its first application to anaesthesia. Prof Pollard said that a huge amount of research still needed to be done to fully understand the role EIT could play in medicine.

“If its power can be harnessed, then it has the potential to make a huge impact on many areas of imaging in medicine. It should help us to better understand anaesthesia, sedation and unconsciousness, although its place in medicine is more likely to be in diagnosing changes to the brain that occur as a result of, for example, head injury, stroke and dementia.

“The biggest hurdle is working out what we are seeing and exactly what it means, and this will be an ongoing challenge,” he concluded.

* fEITER was invented at The University of Manchester and developed with funding from The Wellcome Trust (from 2005 to 2011). fEITER has patent protection in Europe with patents pending in the USA. The technology is available to license from UMIP, The University of Manchester’s IP commercialisation company.

---

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by ESA (European Society of Anaesthesiology), via EurekAlert!, a service of AAAS.

---

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Product Details:

• Date: From Jan. to June 2010
• Format: 6 PDFs
• Size: 58 Mb
• ISBN: 0007-0912
• Publisher: Oxford Journals

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Synopsis
Founded in 1923, one year after the first anaesthetic journal was published by the International Anaesthesia Research Society, BJA remains the oldest and largest independent journal of anaesthesia. It became the journal of The College of Anaesthetists in 1990. The College was granted a Royal Charter in 1992. Although there are educational links between BJA and the College, the journal retains editorial independence.

BJA publishes original articles in all branches of Anaesthesia. Submitted manuscripts are subject to stringent review to ensure that the journal only contains papers of the highest standard.

Publisher: Cambridge University Press
Number Of Pages: 284
Publication Date: 2007-04-09
ISBN / ASIN: 0521870909

Book Description:
One major by-product of the aging baby-boom generation is a surging interest in cosmetic surgery. Although procedures like facelifts and abdominoplasties (the ˜tummy-tuck’) are considered minimally invasive, the anesthetic protocols and regimens here are often overly complex and unnecessarily toxic. This reference will focus on all of the procedures that the anesthesiologist needs to be proficient in to adequately care for this group of patients. Perioperative care and pain management will be covered for the full spectrum of operations, and there will be special emphasis on level-of-consciousness
monitoring of these patients

Pain Medicine: The Requisites in Anesthesiology (Requisites in Anesthesia)
By Stephen Abram

• Publisher: Mosby
• Number Of Pages: 256
• Publication Date: 2006-03-13
• ISBN-10 / ASIN: 0323028314
• ISBN-13 / EAN: 9780323028318

Product Description:

This new volume in the REQUISITES IN ANESTHESIA Series thoroughly but concisely covers the many diverse aspects of pain medicine. It explains all of the basic principles, clinical concepts, and management options involved in providing anesthesia for patients suffering from a range of pain inducing syndromes, including psychological testing. And, it discusses recent advances and changing trends in anesthetic care. A user-friendly format, with many at-a-glance tables and boxes, makes clinical information easy to access. * Covers a full range of Pain Syndromes, enabling quick review * Illustrates all aspects of Pain Medicine using new artwork for anatomic and physiologic topics * Provides easy to remember “Pearls” through key-points boxes and a chapter outline at the beginning of each chapter * Presents all the information on pain medicine needed to certify or recertify in Anaesthesiology

http://www.book4doc.com/41813

Anesthesia Secrets
By James Duke MD MBA

• Publisher: Mosby
• Number Of Pages: 592
• Publication Date: 2010-03-16
• ISBN-10 / ASIN: 0323065244
• ISBN-13 / EAN: 9780323065245

Product Description:

Anesthesia Secrets, 4th Edition by James Duke, MD has the quick answers you need for practice and review. It uses the popular question-and-answer format of the Secrets Series to make essential guidance easy to reference and study. A list of the Top 100 Secrets in anesthesiology lets you review the most frequently encountered board review questions at a glance; and an informal tone, user-friendly format, and pocket size make the book both convenient and portable.

• A section on the Top 100 Secrets in anesthesiology provides you with a high-yield overview of essential material for study or self assessment.

A question-and-answer format, Key Points boxes, bulleted lists, mnemonics, and a two-color page layout make information remarkably easy to reference and review.

Practical tips from the authors provide valuable insights into best practices.

The book’s portable size lets you carry it comfortably in your lab coat pocket.

• Thorough updates throughout equip you with the most up-to-date information on all areas of anesthesia, including the most current standards of care.

http://www.book4doc.com/13485
http://www.book4doc.com/57742

Core Topics in Airway Management
By Ian Calder, Adrian Pearce

• Publisher: Cambridge University Press
• Number Of Pages: 209
• Publication Date: 2005-02-06
• ISBN-10 / ASIN: 0521869102
• ISBN-13 / EAN: 9780521869102

Product Description:

This book provides an easy-to-read introduction to this important topic that will be of value to a wide spectrum of healthcare professionals including anaesthetists, intensivists, ODPs, theatre and recovery nurses. Concise but comprehensive chapters from experts in the field cover everything from basic anatomy, physiology and applied physics, through the various methods of maintaining the airway under anaesthesia (supraglottic devices, tracheal intubation, tubes/cuffs, endobronchial and double-lumen tubes) to the problem airway (obstruction by infection, tumour or a foreign body, ENT and maxillo-facial surgery, aspiration, obstetrics, trauma, cervical spine disease, intensive care, the ‘lost’ airway, extubation and recovery), the paediatric airway, disinfection and cleaning of equipment and finally morbidity, mortality and medico-legal issues. ‘Real’ clinical scenarios, with patient management questions and model answers, are included throughout, to bring to life some of the key problems encountered in day-to-day practice and enhance the book’s utility as a teaching and self-learning tool.

Aimed at a broad readership, including anaesthetic, surgical, medical, ODP and nursing personnel Short, practically orientated chapters designed for ease of reference More concise and affordable than equivalent titles, but still comprehensive in its breadth of coverage

http://www.book4doc.com/17405

http://www.book4doc.com/31794

Neurosurgical Pain Management
By Kenneth Follett

• Publisher: Saunders
• Number Of Pages: 500
• Publication Date: 2004-04-30
• ISBN-10 / ASIN: 0721692419
• ISBN-13 / EAN: 9780721692418

Product Description:

Written exclusively from a neurosurgical perspective, this title is a concise and practical resource, yet covers a large information base from Myofascial Pain Syndromes to Peripheral Ablative Techniques. Organized into four sections: Fundamental Considerations in Pain Treatment, Pain Syndromes of Neurosurgical Importance, Neurosurgical Pain Therapies, and Miscellaneous Topics (which includes Physical Medicine and Rehabilitaion, Disability and Impairment in the Patient, and more).

http://www.book4doc.com/49289