Der Anaesthesist

, Volume 59, Issue 3, pp 199–209 | Cite as

Negative und positive Suggestionen in der Anästhesie

Verbesserte Kommunikation mit ängstlichen Patienten bei Operationen
Leitthema
First Online:

Zusammenfassung

Patienten in Extremsituationen wie einem medizinischen Notfall oder vor einem operativen Eingriff zeigen eine erhöhte Aufmerksamkeit und Empfänglichkeit für Suggestionen. In diesem Trance-ähnlichen Zustand können unbedacht ausgesprochene Negativsuggestionen Angst und Schmerzen verstärken, können aber andererseits auch Positivsuggestionen zum Wohl der Patienten eingesetzt werden. Erfahrungen und Methoden aus der Hypnotherapie wie Utilisation, „reframing“, indirekte Suggestion, innerer Ruheort, Dissoziation, Metapher oder posthypnotischer Auftrag und ebenso nonverbale Kommunikation lassen sich auch ohne formelle Hypnoseinduktion und ohne zusätzlichen zeitlichen, räumlichen und personellen Bedarf nutzen, um generell den Umgang mit ängstlichen Patienten bei schmerzhaften und belastenden medizinischen Maßnahmen zu verbessern. Indikationen für ein solches Vorgehen sind v. a. das Narkosegespräch, die Narkoseeinleitung sowie Eingriffe in Lokal- oder Regionalanästhesie bis hin zur Patientenbegleitung bei Wachkraniotomie unter kranialen Leitungsblockaden und in Wach-Wach-Technik ohne zentral wirksame Medikamente. Hypnotische Kommunikation erlaubt es, dem Patienten Selbstkontrolle zurückzugeben und innere Ressourcen zugänglich zu machen.

Schlüsselwörter

Suggestion Kommunikation Angst Schmerz Regionalanästhesie 

Negative and positive suggestions in anaesthesia

Improved communication with anxious surgical patients

Abstract

In extreme situations, for example during emergencies or when facing surgery, patients exhibit heightened and focused attention and increased susceptibility to suggestion. In this trance-like state negative suggestion, usually spoken unintentionally can aggravate anxiety, stress and pain. On the other hand words can offer an opportunity to benefit the patient via positive suggestion. In order to improve communication with anxious patients during stressful and painful medical procedures, certain hypnotherapeutic insights and methods can be employed, such as utilization, reframing, indirect suggestion, safe place, dissociation, metaphors, posthypnotic instructions and non-verbal communication and this without requiring formal hypnotic induction and without need for additional time, premises or personnel. Indications for such approaches are the preoperative visit, induction of anaesthesia, as well as operations under local or regional anaesthesia. An extreme example of the latter is awake craniotomy employing cranial nerve blocks and an awake-awake technique avoiding centrally acting drugs. Such hypnotic communication can help the patient to regain self-control and access to inner resources.

Keywords

Suggestion Communication Anxiety Pain Regional anaesthesia 
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Notes

Interessenkonflikt

Es besteht kein Interessenkonflikt.

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Copyright information

© Springer Medizin Verlag 2010

Authors and Affiliations

  1. 1.Klinik für AnästhesiologieUniversitätsklinikum RegensburgRegensburgDeutschland
  2. 2.-Santa BarbaraUSA

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