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Vibration felt during the burr hole procedure and removal of the bone flap are the most negatively reported stages of the procedure. Hypnosis seemed to ameliorate the unpleasantness of these and other surgical events. For example, administering local anesthetics during opening and closing is the most painful part of the surgery, yet few patients even mentioned it. Patients may be experiencing a diminution of pain as the hypnotic trance intensifies.

Interestingly, although some patients’ rating scales showed high stress levels, the patients reported that they found the hypnosis to be a positive experience. Even the 1 patient whose evaluation score indicated posttraumatic stress disorder following the procedure reported his experience with hypnosis as positive, and he continues to use the technique in his everyday life.

The success of hypnosis was more about patients’ motivation and less about how hypnotizable a patient was, and all but two of the patients said that if they needed another awake craniotomy, they would choose hypnosedation.

The neurosurgical team concluded, however, that hypnosedation in LGG resection is not a replacement for the AAA method, which they consider to be the gold standard. Hypnosedation requires too great an investment in preparation and commitment for the team and the patient, but suggest that it can be an alternative to fully awake surgery in older patients.

Bette Weinstein Kaplan is a medical writer based in Tenafly, New Jersey.


1. Zemmoura I, Fournier E, El-Hage W, Jolly V, Destrieux C, Velut S. Hypnosis for awake surgery of low-grade gliomas: description of the method and psychological assessment. Neurosurgery. 2016;78(1):53-61. doi:10.1227/NEU.0000000000000993.