Title: "Touching the unconscious in the unconscious - Suggestions are effective even when given under general anesthesia"
Presenters: Ernil Hansen
Didactic centre of the Faculty of Law and Administration (Krupnicza 33A)     
Wydział Prawa i Administracji Uniwersytetu Jagiellońskiego (Krupnicza 33A)    

Room 12 / Sala 12

Time: 20- 30 minute presentation during 8th pararell sesion- 14.06.2024 16:00-17:30

Language: EN


We report (published in BMJ) on a randomized, controlled blinded multicenter study on 385 patients undergoing surgery of 1-3 hours duration under controlled general anesthesia, where a taped 20-min text with positive suggestions were played repeatedly under controlled deep anesthesia. Postoperative pain (NRS) was significantly lower (by 25%) in the intervention group. Number of patients needed to be treated (NNT) to avoid NRS≥3, the common threshold for pain medication, was 5.3. Accordingly, postoperative opioids were significantly reduced by one third. NNT to avoid opioid application was 6, an increase in the number of patients without need for opioids and non-opioid analgesics by 60-80%. Pain and analgesics use are not independent parameters; however, their correlation diminished by the intervention, suggesting development of pain tolerance. Further significant effects were observed on postoperative nausea and vomiting, on the need for antiemetics, and on recovery from anesthesia.
Our study provides evidence that meaningful suggestions reach and affect patients even under general anesthesia, and demonstrates a feasible, low-cost, non-pharmacological intervention to reduce medication and side effects of surgery and anesthesia. Compared to hypnosis for medical interventions the observed effects were at least as strong or even higher with the suggestions given under general anesthesia, however with much less effort. Compared to older trials on intraoperative suggestions as reviewed in the meta-analysis, the observed effects were much stronger. The results of this study call for wide application of therapeutic suggestions in surgical patients, should trigger a more careful shielding of patients from negative influences in the OR, and initiate further research on unconscious patients like during intensive care or resuscitation. For hypnosis the presented study inspires a discussion on the role of hypnotic induction and on the substance of therapeutic suggestions.

Ernil Hansen - Professor of Anaesthesiology at the University Hospital Regensburg, Germany. Lectures and workshops about Therapeutic Communication for students, doctors, nurses and hypnotherapists. Scientific board and award winner of Milton-Erickson-Society of Germany.