L’hypnosédation, un nouveau mode d’anesthésie pour la chirurgie endocrinienne cervicale. Étude prospective randomisée

Abstract

Retrospective studies have confirmed the feasibility and safety of thyroid and parathyroid procedures performed under hypnoanesthesia (hypnosis, local anesthesia and minimal conscious sedation) as sole method of anesthesia. This very effective technique seems to provide physiological, psychological and economic benefits for the patient.Study aim: To assess, by means of a prospective randomized study, the advantages of hypnosedation as an alternative to general anesthesia in terms of clinical and laboratory parameters.Patients and methods: Twenty patients operated under hypnoanesthesia were compared to 20 patients operated under conventional anesthesia. The two groups were compared in terms of inflammatory, neuroendocrine, hemodynamic and immunologic parameters and postoperative course (pain, fatigue, muscle strength and stress).Results: No clinical or demographic differences were observed between the two groups. Operative times, bleeding, weight of specimens, and surgical comfort were similar. Significant differences in terms of inflammatory response and hemodynamic parameters were observed in favor of hypnoanesthesia. Neuroendocrine and immunological parameters were similar. Patients of the hypnoanesthesia group had significantly less postoperative pain. Postoperative fatigue syndrome and convalescence were significantly improved in these patients.Conclusion: This study confirms that, in our hands, hypnosedation presents real advantages over general anesthesia, in patients undergoing thyroid surgery.