APPLICATION OF HYPNOANALGESIA FOR THE TREATMENT OF CHRONIC CANCERPAIN - REPORT OF ONE CASE

應用催眠止痛於治療慢性癌症痛－病例報告

吳宗正(Tzong-Jeng Wu)；孫維仁(Wei-Zen Sun)；劉健強(Kien-Cuong Luu)；林仙養(Shian-Yeang Lin)

Acta Anaesthesiologica Sinica

28卷3期（1990 / 09 / 01）

361 - 365

英文

The use of hypnosis in anesthesia was first reported in 1821. Since then, many reports have demonstrated that hypnosis, as an adjuvant or alone, was effective in the treatment of cancer pain in hypnotizable patients. Nausea and vomiting which were commonly found in patients during chemotherapy have also been reported to be relieved by hypnosis. We describe our experience in treatment of abdominal pain in one patient with metastatic gastric cancer. He showed physical and psychological intolerance to opioid treatment was managed by hypnoanalgesia as alternative pain therapy. Both visual analogue pain scale and his daily requirement of narcotics were used to evaluate the effectiveness of hypnoanalgesia.

本例為一位59歲本省籍男性，診斷有胃癌合併全身性轉移，曾接受全胃切除手術及化學治療。因上腹持續性鈍痛併間歇性絞痛，在每天使用Meperidine 50mg肌肉注射四次仍不能有效減輕時，被照會至本科做止痛治療。經理學檢查及詢問病史後，評估其疼痛包含臟器性（Visceral），體幹性（Somatic）及心因性（Psyc hogenic）疼痛。因為病人不願使用侵犯性的止痛治療，如硬膜外嗎啡等。經病人同意後，嘗試使用催眠止痛（Hypnoanalgesia）。經三次異體催眠治療（Heterohypnosis）給予後催眠止痛暗示，並學習自我催眠（Self-hypnosis）以維持止痛效果。病人每天止痛所需Meperidine最顯著減少，最後可以停藥。停止異體催眠治療五天後，因逐漸疼痛，每天所需Meperidine劑量，逐漸回升。催眠止痛因無毒性，可作為藥物止痛的輔助方法。在某些病人不能使用藥物治療疼痛時，如果病人可接受催眠，我們建議使用催眠止痛。