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Virtual reality (VR), or computer-simulated 3D reality, can guide patients into deep states of hypnosis—so deep that they can undergo light surgery and dental procedures without pain or anxiety. The introduction of anesthesia over 200 years ago, beginning with ether and the development of better anesthetics used today in operating rooms, has ushered in a fantastic era of surgical intervention. Hypnosis refers to the mental state resembling sleep in which the subject (usually guided by a hypnotist) loses awareness of their surroundings and becomes easily suggestible. Although science does not understand precisely how hypnosis works, the medical community, including psychologists and anesthesiologists, have recognized for years the therapeutic power of hypnosis to manage pain, reduce anxiety, and improve surgical outcomes.
A spectacular example of hypnosis in the operating room appeared in a research article published in October 1959 in the Journal of the American Medical Association authored by Dr. Milton J. Marmer. In the article, Dr. Marmer describes the use of hypnoanesthesia to manage pain in eight patients undergoing incisions into the chest wall to treat heart disease. One patient, a forty-two-year-old female received hypnosis and only a local anesthetic for the incision and a muscle relaxer to facilitate the insertion of a tube down her throat. She underwent a procedure called mitral commissurotomy in which the surgeon removes calcium deposits from the heart valve. According to the report, “this patient was able to remove the tube herself, required no postoperative narcotics or sedatives, and manifested total operative amnesia. It is concluded that the reassurance which can be induced by hypnosis allays fear, anxiety, and tension more effectively than do the tranquilizing drugs.” (JAMA.com)
Multiple reviews and clinical studies support the application of hypnosedation and hypnoanalgesia in the operating room. Hypnosis requires skilled clinical hypnotists, which depends on the individual hypnotist-patient relationship. The one-on-one relationship does not scale to every operating room across the country because there simply are not enough hypnotists to go around. However, virtual reality offers a new opportunity to extend the use of hypnosis in pain management, sedation, and anxiety to many more patients than a single hypnotist could ever reach. A VR distraction device called OperaVR Digital Nitrous developed by Patterson Dental addresses anxiety associated with dental visits. Studies support the assertion that OperaVR, through its depiction of vivid, engrossing images and sound, provides the same effects as nitrous oxide to relieve stress without the need for gas delivery or continuous patient monitoring. (digitalnitrous.com)
Beyond using virtual reality for distraction, a more advanced VR system combines sound and visuals to guide the patient into a hypnotic state. The company, based in Brussels, Belgium, called OnComfort, has developed several VR devices to help manage pain and anxiety associated with regional surgery and chemotherapy. One instance of the OnComfort system guides patient hypnosis with an animated whale that the patient follows through undersea worlds and uses the up and down motion of the tail to guide breathing and induce trance. OnComfort’s device called Sedakit has received clinical approval in the European Union as a non-pharmacological medical device for the clinical management of pain and anxiety through digital sedation.
The pain and anxiety associated with surgery and dental procedures affect a significant proportion of patients. The development of anesthesia over the past 200 years has ushered in the possibility of a remarkable variety of surgical interventions from heart surgery to life-saving procedures to save acute trauma patients. Despite the exceptional benefits from anesthesia, risks still exist for side effects and even death. Hypnosis administered by a clinical hypnotist offers an alternative form of pain management that has shown clinical efficacy for many years. However, a hypnotist can only work with one patient at a time, severely limiting patient access to clinical hypnosis. Recent developments in virtual reality demonstrate the clinical hypnosis can now scale to reach every operating room and clinical setting. Companies such as OperaVR and OnComfort offer promising products that use innate human capability for hypnosis to manage pain and anxiety without drugs. Scalable virtual reality systems for pain and anxiety management around surgery and dentistry promise to open the door to new digital modalities that take advantage of the inherent capabilities of human psychology.
Dr. Smith’s career in scientific and information research spans the areas of bioinformatics, artificial intelligence, toxicology, and chemistry. He has published a number of peer-reviewed scientific papers. He has worked over the past seventeen years developing advanced analytics, machine learning, and knowledge management tools to enable research and support high level decision making. Tim completed his Ph.D. in Toxicology at Cornell University and a Bachelor of Science in chemistry from the University of Washington.
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