Authors: Reme SE et al.
Journal: Anesthesiology, December 8, 2025. DOI: 10.1097/ALN.0000000000005821
Summary
This randomized clinical trial compared the effects of a brief preoperative hypnosis session versus mindfulness on postoperative symptoms in women undergoing breast cancer surgery. Recognizing that breast surgery is frequently associated with fatigue, emotional distress, pain, and nausea—and that preoperative anxiety can worsen these outcomes—the investigators evaluated whether hypnosis offers advantages over an active behavioral control.
A total of 203 women were randomized to receive either hypnosis or mindfulness within two hours prior to surgery. Postoperative symptoms were assessed after emergence from general anesthesia using visual analog scales, and perioperative anesthetic and opioid use was extracted from medical records.
Patients who received preoperative hypnosis experienced significantly less postoperative fatigue and emotional distress compared with those who underwent mindfulness. In addition, the hypnosis group required lower doses of postoperative fentanyl, suggesting an opioid-sparing effect. The benefit of hypnosis on emotional distress was particularly pronounced in patients with higher levels of preoperative anxiety, indicating that baseline psychological state moderates treatment response.
No significant differences were observed between groups for postoperative pain, nausea, or general discomfort, and no adverse events related to either intervention were reported. Overall, hypnosis demonstrated selective benefits on emotional and fatigue-related outcomes rather than nociceptive symptoms.
The findings suggest that even a single, short hypnosis session immediately before surgery may meaningfully improve certain aspects of early postoperative recovery and reduce opioid requirements, particularly in anxious patients.
Key Points
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Preoperative hypnosis reduced postoperative fatigue and emotional distress compared with mindfulness.
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Patients receiving hypnosis required less postoperative fentanyl.
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Benefits on emotional distress were greater in patients with higher preoperative anxiety.
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No differences were observed in postoperative pain, nausea, or discomfort.
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Both interventions were safe, with no reported adverse events.
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Hypnosis represents a promising nonpharmacologic adjunct to perioperative care in breast surgery.
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