Dec. 1, 1999 (Chicago) -- Doctors at Harvard's Beth Israel Deaconess Medical
Dec. 1, 1999 (Chicago) -- Doctors at Harvard's Beth Israel Deaconess Medical Center are tapping into patients' ability to find comfort in the subconscious before tapping into their veins with catheters, and this "new age" approach is winning enthusiasts among both patients and staff.
Elvira V. Lang, MD, associate professor of radiology and medicine at Harvard Medical School in Boston, reported a study of self-hypnosis techniques at the 85th Scientific Assembly and Annual Meeting of the Radiological Society of North America. Although her study included only 161 patients who were offered the hypnosis relaxation approach, she says that by early next year, all patients undergoing procedures in the catheterization lab at Beth Israel Deaconess Medical Center will have the option of using hypnosis to either replace or supplement traditional conscious sedation. Conscious sedation usually consists of the patient receiving one or more drugs that aid in anxiety and pain relief.
Lang tells WebMD that by using hypnotic relaxation -- basically, using a set script to lead a patient into deep relaxation by suggesting that the patient "concentrate on the sensation of floating and float to some place comfortable" -- her hospital saves more than $100 on each procedure, a potential annual savings of $1 million. The hospital is so enthusiastic that "we are currently training our entire team in the technique." She says that care nurses and technicians require about 32 hours of training. She has worked "five years to develop our standard script, and it hasn't failed us yet."
In her study, the technique was offered to 161 patients undergoing angiography, angioplasty, or kidney drainage, but she says that it can be used with any catheter-based procedure in which conscious sedation is used. "Use of the hypnotic procedure cut procedure time from 78 minutes for our standard care group to an average of 61 minutes for the hypnosis group," she says.
According to Lang, patients who undergo the technique can still receive both pain and anxiety medications and are given a bell to signal when they want to receive medication. Patients who underwent the procedures without hypnosis used "an average of 1.9 units of drugs, compared to an average drug use of 0.9 units for patients using hypnosis."
Of the 161 patients in the study, 79 patients did not undergo relaxation techniques; 82 did opt for the relaxation approach. "Forty-six percent of the patients using hypnosis used no conscious sedation, while only 18% of the patients in the standard treatment group requested no sedation," she says.
She says that patients each select a "familiar comfortable place. ... Many chose settings in nature, but one woman said she went home to can vegetables. Another woman said she sat on the clouds with her deceased relatives and floated around touring the country."
She says that the relaxation approach benefits not only the patient but the operators and cath lab staff as well. For example, she says that when she was placing a shunt in a liver, a complication occurred while the patient was using the relaxation technique. "This man had gone to New York, where he was the Statue of Liberty, which was great because statues don't move. But then we had this happen and our anxiety started to rise, so the care nurse told the man that statues often need restoration work that needs to be done by experts. She told the man that we were now calling in a team of restoration experts to work on the Statue of Liberty," she says. "It worked great because we had the chance to calm down and we realized that the situation wasn't really that bad."
She says that patients who opt to use hypnosis are generally very satisfied and report that they would be willing to use it again.
Lang says that she started using the hypnosis technique about 10 years ago when she encountered difficulty replacing "a drainage tube. It should have been very easy, but it wasn't. My technician had studied hypnotism and suggested that we try that. It worked like a charm. I am a pragmatist, when I saw that it worked, I was sold." She describes it as the "perfect combination of high technology and high touch."
Vital Information:
- Hypnosis can be an effective supplement or replacement to traditional conscious sedation in patients undergoing procedures that involve catheterization.
- The length of time needed to perform the procedure and the amount of drugs used were lower in patients who elected to undergo self-hypnosis.
- Nearly half of patients who used the relaxation technique did not ask for any sedation; this was true for only one-fifth of patients not using hypnosis.
