Perioperative hypnosis reduces hospitalization in patients undergoing the Nuss procedure for pectus excavatum.

ABSTRACT

PURPOSE: To assess whether perioperative hypnosis can reduce the length of hospitalization and alter the need for postoperative analgesics in patients undergoing the Nuss procedure. MATERIALS AND METHODS: Ten consecutive patients (age range, 12-18 years) underwent the Nuss procedure with the same operative technique. For pain management they were divided into two sequential groups the 5 patients in the nonhypnosis group were managed with an epidural catheter, and analgesia was supplemented with intravenous or oral narcotics as requested. These patients all required Foley catheters for bladder drainage while the epidural was in place. The second group of 5 patients was prepared by teaching them self-hypnosis for postoperative pain management in one or two brief sessions. Postoperative self-hypnosis was prescribed and encouraged. These patients were allowed patient controlled analgesia and were supplemented with intravenous or oral narcotics as requested. Four of the patients in this group required a straight catheterization of the bladder the evening of surgery. Data collected included hospitalization and analgesia requirements as well as other unusual findings. RESULTS: The patients in the hypnosis group spend an average of 2.8 days in the hospital compared with 4.6 days in the nonhypnosis group (p < 0.01). There was also a trend toward less parenteral narcotic use. Postoperative discomfort was better controlled with oral analgesics in the hypnosis group. There were no adverse effects from the hypnosis. CONCLUSION: In this small study, perioperative hypnosis was associated with a reduced hospital stay in patients undergoing the Nuss procedure for pectus excavatum.