Tuesday, August 26, 2014

Not All Anesthesia Is General. Duh.

Here is a headline from the Dallas Morning News that seems to describe a miraculous new technique for providing anesthesia, "Would you give up anesthesia for hypnosis?" The article starts off by teasing what seemed to be the impossible, and the death of anesthesiology, "Bob Dick recently toughed his way through a 90-minute total knee replacement without the aid of anesthesia, choosing to stay awake through the chisel and the buzz of the electric saw."

Uh oh, I thought. Were all those years of anesthesia residency for naught when a patient can go through a highly invasive procedure like a knee replacement without my intervention? The paper describes the psychologist's technique for surviving such an operation, "he started breathing deeply, a signal for his body to relax. Next he held his thumb and forefinger together, imagining a walk around the pond at his home." Wow! Is that all there is to it to avoid pain during an operation?

It is not until later in the article does the truth about his new anesthesia replacement come to light. It seems that Dr. Dick had received "nerve blockers" to take away the trauma of the operation. But he doesn't give any credit at all to his anesthesiologist. Instead he gives himself a pat on the back with his self-hypnosis technique, "It's the closest thing to magic I know. I knew it was there. I just wasn't paying attention to it."

He goes on to describe how he was able to undergo a colonoscopy using the same hypnosis approach. Except this time it wasn't as successful because that darn gastroenterologist kept disrupting his trance by asking if he was in any pain.

Dr. Dick, before you start broadcasting to the whole world what a ludicrous claim you are making about self hypnosis as an anesthetic technique, please familiarize yourself first with something called regional anesthesia. It's only been around for a century or so. We anesthesiologists do it every day for orthopedic procedures like yours. Yes our patients also feel no pain. They too can stay awake if they prefer. But most of our patients would rather have a light sedation like some Versed so they don't have to listen to the sounds of the operating room. See our patients normally aren't as proficient at hypnotizing themselves as you are. As far as the colonoscopy is concerned, millions of people undergo colonoscopies without any sedation. And they don't have to put themselves into a stupor to do so. That's called toughing it out. Or some people would prefer to say they are taking the scenic view of their colons.

Perhaps the reporter can also do a little more in-depth research on regional anesthesia instead of just regurgitating some sort of feel good public relations fantasy. Here is an informative page from the American Society of Regional Anesthesia and Pain Medicine. And it only took a single Google search to find it. But I guess that would be too much work for a journalist in the Lifestyle section of the paper.

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