Background: This was a prospective, observational study into the effects of pre-operative hypnosis on haemorrhage and pain in open septorhinoplasty. Hypnosis is an interactive method of evoking sensations, perceptions, comprehension and voluntary motor activity in an individual by the hypnotist; and facilitates diversion of attention from disturbing stimuli while making patients feel better.
Methods: This study was carried out on 22 patients undergoing septorhinoplasty under general anaesthesia. Patients in the hypnosis group (HG), were hypnotised in 3 sessions carried out on different times before the operation. The first and the second sessions were performed, respectively, on 3 days and 1 day before surgery. Having been taught self hypnosis, the patients were helped to use self hypnosis at the end of the second session, the aim being to use it for perioperative pain and anxiety. The patients were explained that postoperatively, the painful area would be felt without sensitivity as if placed under ice or snow. Also, after suggestions of being under analgesia the patients were asked to open the eyes and were demonstrated not to feel pain from injector needle pricks. The 3rd session of hypnosis using self hypnosis was carried out before the patient was taken in the operation theatre. In all patients, remifentanil infusion, controlled on the basis of mean arterial pressure, was maintained intraoperatively. Blood presssure, heart rate and oxygen saturation were recorded intra- and postoperatively. The level of bleeding was recorded intraoperatively; and pain intensity was estimated by visual analog scale (VAS); and analgesic drug use was evaluated.
Results: Only the data on 22 of the 27 patients who underwent septorhinoplasty were evaluated statistically. Nor the haemodynamic parameters followed in the intraoperative stage, nor the data on the quality of the surgical field, nor the postoperative analgesic requirement differed significantly between the HG and the CG. However, in the HG, intraoperative total remifentanil use and the VAS scores in the postoperative 2nd and the 3rd hours were significantly lower (p=0.034, p=0.028 and p=0.047, respectively). Additional analgesic administration was needed by only 1 patient in the HG compared to 5 patients in the CG at the recovery room (p=0.149). Also, pain evaluations when removing the nasal tampon, and the need for analgesics postoperatively did not differ significantly between the two groups (p= 0.10, and p>0.05, respectively)

Conclusions: Preoperative use of hypnosis as an additional therapy decreased intraoperative remifentanyl requirement and postoperative pain. However, the use of hypnosis did not affect the quality of the surgical field. The results indicate that adjunctive use of hypnosis has benefical effects on patients perioperatively.

Hypnosis as an adjuvant treatment in open septorhinoplasty