Authors: Reme SE et al.
Anesthesiology. November 07, 2025. DOI: 10.1097/ALN.0000000000005821
Summary:
This randomized clinical trial evaluated whether a brief session of preoperative hypnosis provides greater benefit than preoperative mindfulness in reducing postoperative symptoms after breast cancer surgery. Postoperative pain, fatigue, nausea, discomfort, and emotional distress are common after breast surgery and have meaningful effects on recovery and quality of life. The investigators aimed to determine whether hypnosis, delivered shortly before surgery, could influence these symptoms compared with an active mindfulness control.
A total of 203 women undergoing breast cancer surgery at Oslo University Hospital were randomized to receive either a single preoperative hypnosis session or a session of mindfulness within two hours before surgery. Primary outcomes were postoperative symptoms assessed with 100-mm visual analogue scales in the recovery period. Intraoperative and postoperative anesthetic and analgesic use as well as surgery duration were extracted from medical records.
Patients in the hypnosis group experienced significantly less postoperative fatigue and emotional distress compared with those receiving mindfulness. The effect sizes were small to moderate, with hypnosis reducing fatigue by a mean of 6.4 mm and reducing emotional distress by 5.7 mm. Fentanyl consumption after surgery was also significantly lower in the hypnosis group. Importantly, patients with higher preoperative anxiety demonstrated a greater reduction in postoperative emotional distress when assigned to hypnosis, suggesting that anxiety level may moderate treatment benefit.
No significant differences were observed in postoperative pain, nausea, or discomfort between the two groups. No adverse events attributable to either hypnosis or mindfulness occurred.
The authors conclude that preoperative hypnosis is a safe, non-pharmacologic intervention with benefits for specific postoperative symptoms—particularly fatigue, emotional distress, and opioid use—and may be most effective for patients with elevated preoperative anxiety.
What You Should Know
• A single preoperative hypnosis session reduced postoperative fatigue and emotional distress compared with mindfulness.
• Postoperative fentanyl use was significantly lower in patients who received hypnosis.
• Hypnosis provided greater benefit to patients who entered surgery with higher anxiety levels.
• No differences were found for postoperative pain, nausea, or discomfort.
• No adverse events occurred, supporting hypnosis as a safe, low-risk intervention.
Key Points
• Hypnosis outperformed mindfulness for reducing postoperative fatigue and emotional distress.
• Fentanyl requirements were modestly but significantly lower with hypnosis.
• Preoperative anxiety strengthened the emotional benefit of hypnosis.
• Pain, nausea, and discomfort did not differ between groups.
• Hypnosis is a promising, non-pharmacologic tool that may enhance perioperative recovery.
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