Hypnosedation: Is it possible to have surgery without general anesthesia?

If you were told that there was a way to have surgery painlessly
without general anesthesia, would you try it? Breast cancer survivor Kelly Painter did— and
she has no regrets.

“I would do it again, without a doubt,” says the Dothan, Alabama
resident. “It really was an awesome experience, if you can say that
about breast surgery.”

A lobular breast cancer diagnosis

Kelly came to MD Anderson for a second
opinion in March 2017, after she was diagnosed with stage I breast cancer – specifically, lobular
carcinoma in her left breast

As part of a clinical trial at MD
, she received hypnosedation. This anesthetic technique
consists of hypnosis (a type of guided relaxation exercise),
opioid-sparing strategies and local anesthetic to control pain during
a lumpectomy and sentinel node biopsy (a surgical procedure to remove the tumor). Her
hypnosedation required expertise from our Surgery, Anesthesiology and
Integrative Medicine teams.

When Kelly had her surgery at MD
on April 19, 2017, she was awake, but in a very
relaxed state. This meant she could tell Alastair Thompson, M.D., and his surgical team
immediately if she felt any discomfort. She suffered no nausea or other unpleasant side effects afterward.

“It took a little longer than a traditional surgery because they had
to numb the area with lidocaine,” Kelly says. “But even so, I was in
the operating room at 8:30 a.m., out of surgery by 11:30 a.m., and out
of the hospital by 12:15 p.m. I never even really felt hypnotized, and
the worst pain I felt was a little pinch. It was mostly just pressure.”

Kelly’s recovery was so quick that she was able to drink something
right away. “And I didn’t have to take any pain medicine afterward,”
she notes.

Choosing a hypnosedation clinical trial

Kelly admits she felt “a little apprehensive” when she was first
approached about the hypnosedation clinical trial, which is available only at MD Anderson. Led by Lorenzo Cohen, Ph.D., it explores whether women
who meet certain criteria can avoid using general anesthesia during
breast cancer surgery.

Then Kelly remembered that her doctor had removed tissue using
nothing but local anesthesia when she’d had her MRI and ultrasound
biopsies. “And I just thought, ‘If I could do that, why not this?’”
Kelly says. “The anesthesiologist, Elizabeth Rebello, M.D., will be right there
during the surgery to ensure everything goes smoothly, and I can
always change my mind.”

The best part of a clinical trial: paying it forward

For Kelly, the best part of the clinical trial was knowing that her
participation would help other women.

“My doctor approached me first about another clinical trial
involving pills, but being nine hours away, I don’t live close enough
to be a part of it,” she says. “This is something I can do that’s
going to make the process better for the next person.”

Comprehensive cancer care at MD

Kelly was also impressed with the “whole team approach” she
witnessed at MD Anderson — both in the
operating room and around the hospital.

“During the surgery, they covered me up so I wouldn’t see the
incision, but I could still hear what was going on,” Kelly says. “I
could tell that they all got along and respected one another. Dr.
Thompson even explained why he was using a particular stitch to an
observing student. It was very comforting.”

Kelly was particularly grateful for her care team’s willingness to
schedule her treatment in such a way that she didn’t miss her son’s
college graduation ceremony.

“The doctors at MD Anderson make you
feel like you’re their only patient,” Kelly says. “Everybody’s so
gracious. They all sat and talked with me, and I never felt rushed.
I’m so glad we came here.”

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