Hypnosis and self-hypnosis in hand surgery: Preliminary results of a single-blind randomized study

Hypnosis is a validated complementary anesthesia and analgesia technique. It is primarily used by anesthesia teams but less frequently by surgeons. This technique is widely used in pain management centers for the treatment of chronic postoperative pain, but not for prevention. Ten patients scheduled for hand or wrist surgery by a single surgeon were randomized into two groups. The first group received a preoperative self-hypnosis training session and was instructed to practice hypnosis during the 15 days following surgery. The second group did not receive this preoperative training. Both groups were monitored for 15 days using a self-administered questionnaire that included a visual analog scale for pain, perceived mobility, and anxiety, as well as a QuickDASH score. The number of self-hypnosis sessions and analgesic consumption were recorded. The operating surgeon was blinded to the patient group assignments (single-blind). There was no statistically significant difference between the two groups 15 days post-surgery on the visual analog scales and the Quick-DASH score. Visual analog scales for pain and anxiety were statistically lower during the first 6 post-surgery days. The average number of daily sessions performed was 1.3. Four out of five patients found the sessions easy or moderately easy. No chronic regional pain syndrome was observed in either group. No adverse effects were observed in the hypnosis group. Post-operative self-hypnosis practice by the patient appears to improve subjective outcomes, particularly pain, in the immediate post-operative period. The results of this preliminary study are encouraging but require a larger population and more homogeneous surgical procedures. Hypnosis, and in particular self-hypnosis, is a simple and inexpensive technique. It can be used as an adjunct to conventional analgesics but could also be an effective preventative treatment for chronic local or regional pain syndromes. Its effects are likely well-suited to functional surgeries such as hand surgery.