RESUMO
Between April 1994 and June 1997, 197 thyroidectomies and 21 cervical explorations for hyperparathyroidism were performed under hypnosedation (HYP) and compared to the operative data and postoperative courses of a closely-matched population (n = 121) of patients operated on under general anaesthesia (GA). Conversion from hypnosis to GA was needed in two cases (1%). All surgeons reported better operating conditions for cervicotomy using HYP. All patients having HYP reported a very pleasant experience and had significantly less postoperative pain while analgesic use was significantly reduced in this group. Hospital stay was also significantly shorter, providing a substantial reduction of the medical care costs. The postoperative convalescence was significantly improved after HYP and full return to social or professional activity was significantly shortened. We conclude that HYP is a very efficient technique providing physiological, psychological and economic benefits to the patient.
Assuntos
Anestesia Geral , Sedação Consciente/métodos , Hipnose Anestésica/métodos , Paratireoidectomia , Tireoidectomia , Acetaminofen/análogos & derivados , Acetaminofen/uso terapêutico , Adulto , Analgésicos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Sedação Consciente/efeitos adversos , Feminino , Custos de Cuidados de Saúde , Hospitalização , Humanos , Hiperparatireoidismo/cirurgia , Hipnose Anestésica/efeitos adversos , Complicações Intraoperatórias , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/prevenção & controle , Paratireoidectomia/efeitos adversos , Satisfação do Paciente , Piroxicam/análogos & derivados , Piroxicam/uso terapêutico , Pró-Fármacos/uso terapêutico , Recuperação de Função Fisiológica , Tireoidectomia/efeitos adversosRESUMO
Since 1992, we have used hypnosis routinely in more than 1400 procedures in plastic surgery. Our clinical success and experience with this technique led us to test wether hypnosis using active patient collaboration, could be used as an effective adjunct to conscious intravenous sedation ("hypnosedation", (HS)) for endocrine surgery, as an alternative to general anaesthesia. On a total of 1905 cervical endocrine surgical procedures performed between 1995 and 1998, 296 thyroidectomies and 33 cervical explorations for hyperparathyroidism were conducted under HS. Conversion to GA was needed in three cases (0.9%). All patients having HS reported a very pleasant experience and had significantly less postoperative pain while analgesic use was significantly reduced in this group. Hospital stay was also significantly shorter, providing a substantial reduction of the costs of medical care. The postoperative convalescence was significantly improved after HS and full return to social or professional activity was significantly shortened. We conclude that HS is a very efficient technique that provide physiological, psychological and economic benefits to the patient.