Hypnoanesthesia for endocrine cervical surgery: a statement of practice

To assess the feasibility of endocrine cervical surgery under hypnoanesthesia as a valuable, safe, efficient, and economic alternative to general anesthesia.

Between April 1994 and June 1997, 197 thyroidectomies and 21 cervical explorations for hyperparathyroidism were performed under hypnoanesthesia (HYP) using Erikson's method. Operative data and postoperative course of this initial series were compared to a contemporary population of patients (n = 119) clinically similar except that they declined HYP or were judged unsuitable for it, and who were therefore operated on under general anesthesia (GA).

The surgeons all reported better operating conditions for cervicotomy using HYP. Conversion from hypnosis to GA was needed in two cases (1%). All patients having HYP reported a pleasant experience and, keeping in mind that the GA group is not a randomly assigned control group, both had significantly less postoperative pain and analgesic use. Hospital stay was also significantly shorter, providing a substantial reduction in the costs of medical care. The postoperative convalescence was significantly improved after HYP and a full return to social or professional activity was significantly quicker.

From this study, we conclude that HYP is an effective technique for providing relief of intraoperative and postoperative pain in endocrine cervical surgery. The technique results in high patient satisfaction and better surgical convalescence. This technique can therefore be used in most well-chosen patients and reduces the socioeconomic impact of hospitalization.