Hypnopraxia, a new hypnotic technique for hypnoanesthesia

Various hypnotic techniques are used in anesthesia, either on their own or as adjuncts. A new hypnotic technique, hypnopraxia, was tested in 5 patients undergoing various procedures (4 colonoscopies, 1 inguinal hernia repair, and 1 transobturator tape procedure). The patients were accompanied throughout the procedure by an anesthetist trained in hypnoanesthesia and hypnopraxia. Initially developed for use in hypnotherapy, the accompaniment with hypnopraxia relied on the closeness of the link between the anesthetist and the patient. This was constantly built in the present moment, here and now, by giving back to the patient what the anesthetist observed of the manifestations of the patient's unconscious mind (the patient's speech and choice of words, facial microexpressions, involuntary bodily movements, and emotions). The anesthetist's verbal accompaniment was therefore determined by the patient. No other anesthetic technique was needed during the colonoscopies. For the 2 surgical procedures, some sufentanil was given and local anesthetic was applied by the surgeon. All 5 patients were well satisfied after the procedure. They were especially pleased at having been able to go through their procedure without needing any drug anesthesia, and at being in charge throughout. This preliminary experience with hypnopraxia would tend to show that this technique could be useful in the anesthetic setting. More experience is obviously required with hypnopraxia in anesthesia so as to improve the technique further, and to determine its implications, if any, for the patients and for the procedures. Furthermore, it will be of the greatest interest to determine, before carrying out any procedure with hypnoanesthesia, which patient will benefit most from which hypnotic technique.