Montgomery, G.H., Weltz, C.R., Seltz, M., & Bovbjerg, D.H. (2002). Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. The International Journal of Clinical and Experimental Hypnosis, 50(1), 17–32.

To estimate the effectiveness of adjunctive presurgical hypnosis in the control of symptoms after surgery

• Databases searched were MEDLINE and PsycLIT.
• Search keywords were hypnosis or hypnotherapy and surgery or operation.
• Studies were included in the review if they
  • Included administration of hypnosis to at least one group undergoing surgery
  • Included a control or usual-care group
  • Provided statistical data that allowed calculation of effect sizes

Authors did not report

• Total literature evaluated
• Quality rating of studies described or apparently used in the analysis

• Authors analyzed 20 papers.
• The studies the papers described included 1,624 patients. Overall, sample size was 20–339 participants.
• Of the studies analyzed, two studies involved patients with cancer—one involved patients with head and neck cancer and the other involved women undergoing breast biopsy. These two studies involved a total of 52 patients.

Results demonstrated an effect size of D = 1.17 (95% CI 0.41–1.93) in favor of presurgical hypnosis as a means of decreasing pain severity. The effect size regarding impact on pain medication was D = 1.69 (95% CI 0.56–2.82). Results were similar whether hypnosis intervention was provided by tape or by means of a live session. Mean effect size, across several clinical outcome categories in studies involving cancer, was 0.63 in cases of head and neck cancer and 0.9 in cases of excisional breast biopsy.

This analysis demonstrated that adjunctive presurgical hypnosis helped control postoperative pain in the majority of patients undergoing various types of surgery.

• Only two of these studies related to patients with cancer. Both of these studies had small sample sizes.
• The majority of studies did not provide an attentional control condition.
• Authors provided no analysis of heterogeneity among the studies.

Findings suggest a positive effect of presurgical hypnosis, delivered by tape or in a live session, for the management of the postoperative pain of surgical patients. This report and findings are limited by lack of information about how pain was measured, failure to examine heterogeneity in pooled data, and lack of information about the timing of outcome measures. Findings are also limited by the lack of attentional control conditions in the majority of studies and the lack of randomization in more than half the studies. The sample spans about 40 years. This meta-analysis does not provide strong evidence for the use of presurgical hypnosis as a way to decrease the postsurgical pain of patients with cancer.