[Hypnosis--a side effect-free alternative to medical sedation in regional anesthesia]

Hypnosis can be an alternative to cerebral sedatives with no side effects for sedation during regional anaesthesia, especially in high-risk and fearful patients. Patients who have experience with relating techniques like Jakobson's progressive muscle relaxation are very good candidates for hypnosis. It is contraindicated in patients with psychotic disorders, major depression, and abuse of hallucinogenic drugs. The authors shows his personal method of hypnosis based on fixation and suggestive techniques like muscle relaxation, temperature sensation, and creation of emotional pictures. Of ten cases, hypnosis was successful in six (vegetative stress symptoms like tachycardia or shivering stopped immediately after induction of hypnosis), not completely successful in two (interruption of hypnosis after 30 min) and unsuccessful in two. Four cases where hypnosis was used during spinal anaesthesia for knee and hip surgery or brachial plexus block for open fixation of Colles' fracture are discussed as examples. As it requires more time (15 to 45 min to inform and test the patient) and special organisational conditions hypnosis will not become a routine procedure, but is still a good alternative for selected cases.