The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain
To improve pain relief for refractory pain condition, spinal cord stimulation (SCS) needs to target the dedicated neuronal fibers within the dorsal columns. Intraoperative feedback from the patient can optimize lead placement but requires “awake surgery”, allowing interaction between patient and sur...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-02-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/2/220 |
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| author | Chantal Wood Gaëlle Martiné Gaëlle Espagne-Dubreuilh Karine Le Goff Maarten Moens Lisa Goudman Sandrine Baron Romain David Nicolas Naïditch Maxime Billot Philippe Rigoard |
| author_facet | Chantal Wood Gaëlle Martiné Gaëlle Espagne-Dubreuilh Karine Le Goff Maarten Moens Lisa Goudman Sandrine Baron Romain David Nicolas Naïditch Maxime Billot Philippe Rigoard |
| author_sort | Chantal Wood |
| collection | DOAJ |
| description | To improve pain relief for refractory pain condition, spinal cord stimulation (SCS) needs to target the dedicated neuronal fibers within the dorsal columns. Intraoperative feedback from the patient can optimize lead placement but requires “awake surgery”, allowing interaction between patient and surgeon. This can produce negative effects like anxiety and stress. To better manage these aspects, we propose to combine intraoperative hypnosis with awake anesthesia. Seventy-four patients (35 females, 22–80 years) presenting with chronic refractory pain, were offered intraoperative hypnosis during awake SCS lead implantation. Interactive conversational hypnosis was used as well as interactive touch, which was enhanced during painful moments during the lead intraoperative programming. All patients participated actively during the intraoperative testing which helped to optimize the lead positioning. They kept an extremely positive memory of the surgery and of the hypnotic experience, despite some painful moments. Pain could be reduced in these patients by using interactions and touch, which works on Gate Control modulation. Positive memory was reinforced by congratulations to create self-confidence and to induce positive expectations, which could reinforce the Diffuse Noxious Inhibitory Controls at the spinal level. Cooperation was improved because the patient was actively participating and thus, much more alert when feedback was required. Combining intraoperative hypnosis with awake anesthesia appears helpful for SCS lead implantation. It enhances patient cooperation, allows optimization of lead positioning, and leads to better pain control, positive and resourceful memory. |
| first_indexed | 2024-03-09T21:29:28Z |
| format | Article |
| id | doaj.art-5a52efd1026541689633a1ea4015a437 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T21:29:28Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-5a52efd1026541689633a1ea4015a4372023-11-23T20:59:53ZengMDPI AGMedicina1010-660X1648-91442022-02-0158222010.3390/medicina58020220The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic PainChantal Wood0Gaëlle Martiné1Gaëlle Espagne-Dubreuilh2Karine Le Goff3Maarten Moens4Lisa Goudman5Sandrine Baron6Romain David7Nicolas Naïditch8Maxime Billot9Philippe Rigoard10PRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, FranceClinique François Chénieux, Polyclinique de Limoges, 87000 Limoges, FrancePain Center, Limoges University Hospital, 87000 Limoges, FranceClinique François Chénieux, Polyclinique de Limoges, 87000 Limoges, FranceDepartment of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, BelgiumDepartment of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, BelgiumPRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, FrancePRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, FrancePRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, FrancePRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, FrancePRISMATICS Lab (Predictive Research in Spine/Neuromodulation Management and Thoracic Innovation/Cardiac Surgery), Poitiers University Hospital, 86021 Poitiers, FranceTo improve pain relief for refractory pain condition, spinal cord stimulation (SCS) needs to target the dedicated neuronal fibers within the dorsal columns. Intraoperative feedback from the patient can optimize lead placement but requires “awake surgery”, allowing interaction between patient and surgeon. This can produce negative effects like anxiety and stress. To better manage these aspects, we propose to combine intraoperative hypnosis with awake anesthesia. Seventy-four patients (35 females, 22–80 years) presenting with chronic refractory pain, were offered intraoperative hypnosis during awake SCS lead implantation. Interactive conversational hypnosis was used as well as interactive touch, which was enhanced during painful moments during the lead intraoperative programming. All patients participated actively during the intraoperative testing which helped to optimize the lead positioning. They kept an extremely positive memory of the surgery and of the hypnotic experience, despite some painful moments. Pain could be reduced in these patients by using interactions and touch, which works on Gate Control modulation. Positive memory was reinforced by congratulations to create self-confidence and to induce positive expectations, which could reinforce the Diffuse Noxious Inhibitory Controls at the spinal level. Cooperation was improved because the patient was actively participating and thus, much more alert when feedback was required. Combining intraoperative hypnosis with awake anesthesia appears helpful for SCS lead implantation. It enhances patient cooperation, allows optimization of lead positioning, and leads to better pain control, positive and resourceful memory.https://www.mdpi.com/1648-9144/58/2/220persistent spinal pain syndrome (PSPS)failed back surgery syndrome (FBSS)neuromodulationchronic painsurgeryadjunct therapy |
| spellingShingle | Chantal Wood Gaëlle Martiné Gaëlle Espagne-Dubreuilh Karine Le Goff Maarten Moens Lisa Goudman Sandrine Baron Romain David Nicolas Naïditch Maxime Billot Philippe Rigoard The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain Medicina persistent spinal pain syndrome (PSPS) failed back surgery syndrome (FBSS) neuromodulation chronic pain surgery adjunct therapy |
| title | The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain |
| title_full | The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain |
| title_fullStr | The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain |
| title_full_unstemmed | The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain |
| title_short | The Added Value of Intraoperative Hypnosis during Spinal Cord Stimulation Lead Implantation under Awake Anesthesia in Patients Presenting with Refractory Chronic Pain |
| title_sort | added value of intraoperative hypnosis during spinal cord stimulation lead implantation under awake anesthesia in patients presenting with refractory chronic pain |
| topic | persistent spinal pain syndrome (PSPS) failed back surgery syndrome (FBSS) neuromodulation chronic pain surgery adjunct therapy |
| url | https://www.mdpi.com/1648-9144/58/2/220 |
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