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PubMed1995

A comparison of the hypnotic experience between signing deaf and hearing participants.

This study compared the hypnotic responsiveness of 17 hearing and 34 deaf individuals, all of whom received visual induction and hypnotic suggestions via some form of signing. The comparison between deaf and hearing participants was analyzed on five dependent measures: (a) the Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C); (b) participants' individual item performance; (c) overall trance depth; (d) a rapport scale; and (e) a resistance scale measuring attitudes of participants toward the hypnotist. Although all participants showed at least a moderate level of hypnotic responsiveness, the data did not indicate a significant main effect between deaf and hearing participants on any of the dependent measures. However, there was a tendency (p < .08) for hearing participants to show a greater hypnotic responsiveness than deaf participants. Additionally, there was a significant difference between all the signing participants combined when compared to the norming population on three items of the SHSS:C. Clinical and theoretical implications of these data are discussed.

Adult↗
PubMed1997

Preoperative hypnotic techniques reduce consumption of analgesics after surgical removal of third mandibular molars: a brief communication.

The effects of hypnosis in connection with surgery have been described in many clinical publications, but few controlled studies have been published. The aim of the present study was to evaluate the effects of preoperative hypnotic techniques used by patients planned for surgical removal of third mandibular molars. The patients were randomly assigned to an experimental (hypnotic techniques) or a control (no hypnotic techniques) group. During the week before the surgery, the experimental group listened to an audiotape containing a hypnotic relaxation induction. Posthypnotic suggestions of healing and recovery were given on the tape together with advice regarding ways to achieve control over stress and pain. The control group received no hypnotic intervention. Only one surgeon who was not aware of patient group assignments performed all the operations. Thirty-six patients in the control group were compared to 33 patients in the experimental group. Anxiety before the operation increased significantly in the control group but remained at baseline level in the experimental group. Postoperative consumption of analgesics was significantly reduced in the experimental group compared to the control group.

Acetaminophen↗
PubMed1998

The mysterious persistence of hypnotic analgesia.

Hypnotic treatment of pain has a long history and, among hypnotic phenomena, pain relief is a relatively commonplace focus for intervention, yet we lack a conceptual explanation for this treatment. Hilgard's neodissociation theory accounts for the phenomenon of acute hypnotic analgesia, but not of persistent pain relief. Perhaps the enduring effect of hypnotic treatment can be explained at either of two levels: a neurophysiological model or a learning model. This explanation leads to the further question: How does hypnotic treatment of recurring pain achieve enduring relief? Clinical experience suggests a two-component model. First, the clinician communicates specific ideas that strengthen the patient's ability to derive therapeutic support and to develop a sense of openness to the unexplored possibilities for pain relief within the security of nurturing therapeutic relationship. Second, the clinician employs posthypnotic suggestions that capitalize on the patient's particular pain experiences, which simultaneously ameliorate the pain experience, and which, in small, repetitive increments, tend to maintain persistent pain relief over increasing periods of time.

Analgesia↗
PubMed1998

Infant communication and the development of hypnotic responsivity.

The research on the development of hypnotic responsivity indicates that it emerges, ex nihilo, sometime after the age of 3. The measures used to assess hypnotic responsivity rely on complex verbal instructions, thus precluding investigation of infancy. Recent research on infancy, however, suggests that the ontogenesis of hypnotic responsivity is likely to be found in fundamental human capacities that emerge in the first weeks and months of life. The aims of the article are threefold: (a) to demonstrate that infants possess capacities on the nonverbal plane of communication that are analogous to those required for hypnosis; (b) to identify situations in infancy that are analogous to the hypnotic context; and (c) to examine dispositional and relational attributes in infancy that may account for later individual differences in hypnotic responsivity.

Humans↗
PubMed1989

Hypnotic susceptibility and familial handedness.

The possible relationship between hypnotic susceptibility and familiar handedness was examined. In a mass-testing session of students enrolled in introductory psychology classes, subjects were administered the Harvard Group Scale of Hypnotic Susceptibility, Form A and were also required to complete a questionnaire that ascertained information on their dominant handedness and that of their immediate family relatives. Subjects who had immediate sinistral relatives scored significantly lower in hypnotic susceptibility compared to those who had a history of familial dextrality. When immediate relatives of the original subject pool were tested on hypnotic susceptibility level, sinistral relatives scored lower in susceptibility than dextral relatives. This may indicate the existence of a familial component in hypnotic susceptibility.

Adolescent↗
PubMed1991

Central alpha 1-adrenoceptor stimulation functionally antagonizes the hypnotic response to dexmedetomidine, an alpha 2-adrenoceptor agonist.

Previously, we demonstrated that dexmedetomidine, an alpha 2 agonist, produces a hypnotic-anesthetic response in rats via activation of central alpha 2 adrenoceptors and that this response could be enhanced by the alpha 1 antagonist prazosin. In the current experiment we investigated whether central alpha 1 adrenoceptor stimulation antagonizes the alpha 2 adrenoceptor-mediated hypnotic response. Cirazoline, an alpha 1 adrenoceptor agonist that partitions into the central nervous system, attenuated dexmedetomidine's hypnotic response whether administered systemically (0.3-1 mg.kg-1 intraperitoneally [ip]) or centrally (0.1 mg.kg-1 intracerebroventricularly). Prazosin, an alpha 1 adrenoceptor antagonist that effectively crosses the blood-brain barrier, fully blocked cirazoline's attenuating effect on dexmedetomidine-induced hypnosis, whereas doxazosin, which partitions poorly into the brain, did not block cirazoline's effect. Administration of phenylephrine, 0.3-3 mg.kg-1 ip, an alpha 1 adrenoceptor agonist that does not penetrate into the brain, did not attenuate dexmedetomidine's hypnotic effect. These results indicate that central alpha 1-adrenoceptor stimulation functionally antagonizes the hypnotic response to an alpha 2-adrenoceptor agonist. These data underscore the important requirement for alpha 2 adrenoceptor selectivity if these agonists are to be useful in the anesthetic setting.

Adrenergic alpha-Agonists↗
PubMed1999

Dependence of explicit and implicit memory on hypnotic state in trauma patients.

BACKGROUND: It is still unclear whether memory of intraoperative events results entirely from moments of inadequate anesthesia. The current study was designed to determine whether the probability of memory declines with increasing depth of the hypnotic state. METHOD: A list of words was played via headphones during surgery to patients who had suffered acute trauma. Several commonly used indicators of anesthetic effect, including the bispectral index, were recorded during word presentation. First, these indicators served as predictors of the memory performance in a postoperative word stem completion test. Second, general memory performance observed in the first part was separated into explicit and implicit memory using the process dissociation procedure, and then two models of memory were compared: One model assumed that the probability of explicit and implicit memory decreases with increasing depth of hypnotic state (individual differences model), whereas the other assumed equal memory performance for all patients regardless of their level of hypnotic state. RESULTS: General memory performance declined with decreasing bispectral index values. None of the other indicators of hypnotic state were related to general memory performance. Memory was still significant at bispectral index levels between 60 and 40. A comparison of the two models of memory resulted in a better fit of the individual differences model, thus providing evidence of a dependence of explicit and implicit memory on the hypnotic state. Quantification of explicit and implicit memory revealed a significant implicit but no reliable explicit memory performance. CONCLUSIONS: This study clearly indicates that memory is related to the depth of hypnosis. The observed memory performance should be interpreted in terms of implicit memory. Auditory information processing occurred at bispectral index levels between 60 and 40.

Adolescent↗
PubMed1991

The effect of hypnotically induced emotional states on brain potentials evoked by painful argon laser stimulation.

The relationship between pain perception and emotional states is well known. However, the nature of this relationship and how different emotional states affect sensory and cognitive dimensions of pain remains uncertain. Results from experimental investigations are often contradictory, which may be due to methodological difficulties in inducing pain and monitoring physiological responses. In addition, most studies have focused on a single emotion, and data on the relative effects of different emotional states are lacking. In the present study we attempted to eliminate some of these methodological problems. Laser evoked potentials were used as a quantitative correlate to pain perception and were measured in 12 highly hypnotically susceptible subjects during seven conditions: (a) a prehypnotic baseline condition; (b) a neutral hypnotic control condition; (c-e) hypnotically recalled anger, fear, and depression in randomized order; (f) a hypnotically recalled happy condition, and (g) a posthypnotic awake control condition. The pain evoked potentials were significantly decreased in the angry condition and significantly increased in the depressed condition compared with baseline. No differences could be detected for either the happy or the fear-related condition compared with the baseline or neutral hypnotic condition. A significant positive correlation between the subjective intensity of depression and the increase in evoked potentials was found, but none for the other three emotions. The results support earlier findings that clinical depression is related to increased pain perception, and findings that the expression of anger can inhibit the experience of pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Family process and hypnotic susceptibility. A preliminary investigation.

Prior research has found an association between severe punishment during childhood and adult hypnotic susceptibility. The present study investigated family process variables that potentially underlie this association. Two hundred and five college students completed a self-report family process measure and participated in a group hypnotic induction procedure. A subsample of 128 students rated severity and consistency of the punishment they received as children. Subjects with high hypnotic ability reported significantly higher family cohesion than did subjects of low hypnotic ability. A significant linear relation between family cohesion and hypnotizability was also found. Unexpectedly, punishment severity and consistency did not relate to hypnotic susceptibility. Potential causal mechanisms between family process variables and hypnotizability are discussed.

Adolescent↗
PubMed1998

A randomized controlled trial of a drug use review intervention for sedative hypnotic medications.

OBJECTIVES: Drug use review is used by both the public and private sector to influence prescribing behavior and patient drug use. Past interventions mailed to prescribers have had mixed results. The objective was to evaluate the effect of a one-time, mailed intervention on subsequent use of sedative hypnotic medication. METHODS: An experimental design was used. The intervention contained guidelines for the use of sedative hypnotics, a prescriber profile detailing sedative hypnotic prescribing, and a patient profile. Clustering of patients and their shared prescribers was done to avoid contamination bias and statistical problems associated with a lack of independence of observations. Subjects were 189 Washington State Medicaid recipients who had received at least one tablet per day of a sedative hypnotic medication for 1 year and their prescribing physicians or (when information about the physician was lacking) the dispensing pharmacy. RESULTS: A significant reduction in the use of targeted sedative hypnotic medications was measured in the intervention group (-27.6%) versus the control group (-8.5%). In the intervention group, 9.4% of patients began a new prescription for a benzodiazepine not targeted by the drug use review, whereas no control patients had new use of nontarget benzodiazepines. CONCLUSIONS: The intervention achieved a statistically significant decrease in targeted drug use, and the amount of reduction is likely to have decreased the risk of fractures associated with benzodiazepine use. This study adds to the recent evidence that mailed drug use review interventions can have a desirable impact on patient drug use.

Adult↗
PubMed1991

Temazepam 'Planpak', a fixed-dose reduction regimen for withdrawing benzodiazepine hypnotics: results of a general practice survey.

In a general practice survey of the use of Temazepam 'Planpak' ('Planpak'), 31 participating doctors completed questionnaires on 250 patients. Of these, 228 patients had been taking a variety of 8 benzodiazepine hypnotics prior to 'Planpak' therapy while 22 (8.8%) patients received 'Planpak' as a short course, without prior hypnotic therapy. Of the patients being weaned off benzodiazepines with 'Planpak', the majority had been on therapy for longer than 1 year (mean 5.36 +/- 5.58 years, range 0.08 to 22.9 years). Success (68%) or partial success (13%) was achieved in 81% of patients (95% confidence interval 77% to 86%) in terms of total abstinence from or reduced use of hypnotic for at least 1 month after 'Planpak' therapy. Outcome was not related statistically to gender, type, or duration of previous hypnotic therapy. Twenty-six patients received from one to three additional courses of 'Planpak' and 177 (71%) were not taking hypnotics at the time of the survey which represented a mean follow-up of 9.19 +/- 5.36 months (range 1.7 to 36.5 months).

Adolescent↗
PubMed1993

Metoclopramide decreases thiopental hypnotic requirements.

We compared the effect of metoclopramide (MCA) with droperidol (DPD) on thiopental hypnotic requirements in 96 unpremedicated female patients. The study was randomized, double-blind, and placebo-controlled. The response to the verbal command was used as an end-point of anesthesia. Two methods of determination of thiopental hypnotic requirements were used: titration (infusion of thiopental at a rate of 0.5 mg.kg-1 x min-1) until the end-point was reached and construction of the dose-response curve based on bolus injections of predetermined doses of thiopental (with the use of probit analysis). The ED50 value of thiopental determined by probit analysis was reduced after the 0.2 mg/kg MCA administration by 44% (P < 0.0001). The thiopental hypnotic requirements obtained with the titration method were as follows: 5.3 +/- 0.3 mg/kg in control, 4.5 +/- 0.2 mg/kg (delta 14%, P < 0.03) with 0.1 mg/kg MCA, 3.2 +/- 0.2 mg/kg (delta 39%, P < 0.0001) with 0.2 mg/kg MCA, and 2.9 +/- 0.2 mg/kg (delta 45%, P < 0.0001) with 0.4 mg/kg MCA. DPD decreased thiopental hypnotic requirements almost to the same degree as MCA, with the ceiling effect observed at doses of 0.01 and 0.02 mg/kg (delta 44%, P < 0.0001). The results indicate that MCA causes a profound decrease in thiopental hypnotic requirements. The similarity between the thiopental sparing effects of MCA and DPD suggests that the blockade of D2 receptors is the main mechanism underlying this effect.

Adolescent↗
PubMed1991

[Interaction of the hypnotic lormetazepam with central benzodiazepine receptor subtypes omega 1, omega 2 and omega 3].

To clarify the action of lormetazepam, 3-hydroxybenzodiazepine, on the benzodiazepine (BZ) receptor subtypes, effects of lormetazepam on motor performance in the traction test and hexobarbital-induced loss of righting reflex in mice and the binding to BZ receptor subtypes were investigated in comparison with those of other BZ hypnotics. Lormetazepam prolonged the duration of hexobarbital-induced loss of righting reflex. The minimal effective dose (1 mg/kg, p.o.) was higher than that of flunitrazepam, lower than those of diazepam and zopiclone, and the same as those of triazolam and brotizolam. Lormetazepam showed the ataxic effect at 10 mg/kg, p.o., but the separation between its effective doses for the hypnotic and ataxic effects was the largest among the hypnotics tested. In the displacement study on [3H]flumazenil binding to cerebellar and spinal cord membranes, lormetazepam bound with a higher affinity to omega 1 receptor (Ki = 10 nM) than to omega 2 receptor (Ki = 29 nM). The GABA-ratios of lormetazepam to omega 1 and omega 2 receptors were 3.9 and 4.0, respectively; and they were higher and lower than those of flunitrazepam to omega 1 and omega 2 receptors, respectively. In the displacement study on [3H] Ro5-4864 binding to kidney membranes, lormetazepam bound with a lower affinity to the omega 3 receptor (Ki = 213 nM) than flunitrazepam. Thus, lormetazepam was suggested to be a potent hypnotic with weaker ataxic effects than other BZ hypnotics, which may be due to its selective and potent agonistic action on central omega 1 receptors.

Animals↗
PubMed2006

The influence of injection rate on the hypnotic effect of propofol during anesthesia: a randomized trial.

OBJECTIVE: Previous studies suggested that slow injection of propofol may increase the hypnotic effect during induction of anesthesia. The aim of the present study was therefore to investigate whether injection rate of propofol has an influence on its maximum effect. DESIGN: Randomized, single-blind trial. SETTING: This study has been carried out in the operating rooms of a university hospital. An anesthesiologist and a resident performed the study with the aid of changing nursing staff. PARTICIPANTS: We investigated 99 unpremedicated patients aged 18 to 60 years with American Society of Anesthesiologists (ASA) physical status 1-3. INTERVENTIONS: Anesthesia was induced by intravenous injection of propofol (2 mg/kg). Propofol was manually injected in group 1 over a period of 5 s; in group 2 (120-s injection interval), and in group 3 (240-s injection interval), propofol was administered by an injection pump. After loss of consciousness, mask ventilation was performed with 100% oxygen. Bispectral index (BIS) was used to measure the hypnotic effect of propofol. After the decrease of BIS to the minimum value (i.e., maximum hypnotic effect) and the following increase of BIS to 60, the study period was finished and anesthesia was performed according to clinical criteria. OUTCOME MEASURES: We analyzed whether injection speed has an influence on the maximum hypnotic effect of a given dose of propofol (2 mg/kg). RESULTS: BIS(min) marks the maximum electroencephalogram (EEG) effect of the propofol bolus as measured by the BIS. The lowest mean BIS(min) was measured in group 1 (28.7 +/- 10.3). In group 2, BIS(min) was 33.0 (+/-13.9), and in group 3, BIS(min) was 36.4 (+/-11.0). There were no significant differences between group 2 and groups 1 or 3, but there were significant differences between groups 1 and 3. In group 1, BIS(min) was reached after 102.91 s (+/-44.20), in group 2 after 172.33 s (+/-29.76), and in group 3 after 274.21 s (+/-45.40). These differences were statistically significant for all comparisons. In summary, the lowest value for BIS(min) was achieved in the group with the fastest rate of propofol injection (group1, 5 s). The highest BIS(min) was obtained in the group with the slowest rate of injection (group 3, 240 s). The hemodynamic parameters were not significantly different among groups. CONCLUSIONS: The hypnotic peak effect of propofol is lower with extremely slow injection (240 s versus 5 s). For clinically usual injection rates (5 s and 120 s), there was no significant difference in propofol peak effect.

Journal Article↗
PubMed1984

Prism Adaptation in hypnotically limb-anesthetized subjects: more disconfirming data.

Two experiments assessed the effect of hypnotically suggested arm anesthesia on adaptation to displacing prisms. In Study 1, 30 highly susceptible subjects adapted to prisms by pointing at a visual target for 2 min. with their hypnotically anesthetized dominant arm. Suggestion and hypnosis were then "lifted," and subjects were randomly assigned to three groups: subjects in one group were asked to move the hand slowly during the posttest (slow motion); those in a second group were told that hypnotic anesthesia would enable them to overcome displacement aftereffects (hypothesis informed); the remaining subjects (controls) were given no special instructions. During posttesting, all groups showed a significant displacement aftereffect, with no differences occurring between groups. Study 2 followed the same procedure except that during adaptation the usual target was removed and subjects pointed towards a homogeneous backboard. 20 highly susceptible subjects were assigned to an hypothesis-informed or control group immediately before posttesting. All subjects showed a significant displacement aftereffect. Both studies provide further evidence that hypnotic suggestions do not influence automatic perceptual processes. The results of Exp. 2 contradict the suggestion that hypnotic limb anesthesia eliminates the displacement aftereffect when the target is removed during adaptation trials.

Figural Aftereffect↗
PubMed1996

The endogenous eyeblink and hypnotic susceptibility in a real-simulator design.

This study investigated the relationship between hypnotic susceptibility and the endogenous eyeblink with 27 subjects who were assigned to groups of high susceptibles, low susceptibles and simulators on the basis of cutoff scores from the Harvard Group Scales of Hypnotic Susceptibility: Form A and the Stanford Hypnotic Susceptibility Scales: Form C. Using a repeated-measures design, oculomotor data were collected during two separate conditions, waking and hypnotized, while subjects performed a visual task requiring the discrimination of short light flashes (200 ms) from long light flashes (400 ms). Although results partially replicated previous studies, with high susceptibles blinking significantly less than low susceptibles across both conditions, no effect was found for the hypnotic state. Failure of the simulating group to meet assumptions in the waking condition allowed no conclusions regarding impact of task demands on the endogenous eyeblink.

Attention↗
PubMed1975

Flurazepam hydrochloride, a benzodiazepine hypnotic.

Flurazepam hydrochloride is a benzodiazepine derivative marketed for use as a hypnotic agent. Flurazepam is more effective than placebo and is as effective as other hypnotic drugs in most short-term controlled studies. In long-term dosage studies, flurazepam's efficacy persists while other hypnotics become ineffective. Flurazepam has relatively minor effects upon rapid eye movement (REM) sleep and does not lead to REM rebound; this may reduce the likelihood of drug dependence. Flurazepam does not cause enzyme induction and probably presents little hazard of abuse or overdosage. The rational use of hypnotic agents depends as much upon the underlying cause of the sleep disorder as upon the choice of a particular drug. When hypnotic therapy is indicated, flurazepam appears to have advantages over other drugs currently available in the United States.

Animals↗
PubMed1999

[Hypnotic effect in individuals with varying degree of suggestibility].

The paper presents the results of the investigation concerning time and space organization of brain cortex electric activity and peculiarities of autonomic regulation of cardiac functions in 19 healthy individuals, which had a pronounced intention to counteract of hypnotic influence. Taking into consideration the reactions to hypnosis, these individuals were divided into three groups: predisposed to hypnotic suggestion, sensitive (intermediate group) and resistant to hypnotic suggestion. In predisposed individuals there were more pronounced sympathetic influences on cardiac functions and less spectral power of all EEG rhythms, except beta 2-rhythm. In individuals resistant to hypnotic suggestion there was more pronounced alpha-rhythm in brain cortex, while sympathetic influences on the cardiac functions were not so pronounced. All individuals reacted to hypnotic suggestion by a decreasing of the representation of alpha-rhythm and by diminishing initial interhemispheric asymmetry. However, a share of beta-rhythm was increased in predisposed individuals and of theta-rhythm in resistant individuals. In posthypnotic state in resistant persons the correlations of initial EEG rhythms were completely recovered, while in the individuals from the other groups a recovery was observed only in separate EEG frequencies.

Adult↗