Hypnosis in Surgery: A Modern Adjunct to Anesthesia or a Forgotten Art? A Narrative Review

Hypnosis was used for surgical analgesia long before modern chemical anesthesia, yet its role in contemporary perioperative care remains contested. Interest has revived because of the need for opioid-sparing strategies. Still, the literature mixes robust trial evidence with overstated claims about physiological effects, recovery, and digital applications, and a balanced synthesis for anesthesiologists is lacking. This review aimed to clarify the neurophysiological basis, clinical applications, comparative position, and implementation barriers of clinical hypnosis in surgery. A narrative review was conducted of meta-analyses, systematic reviews, randomized controlled trials, neuroimaging studies, surveys, and methodological guidance published between 1996 and 2026, with each claim verified against its primary source. Hypnosis modulates distributed pain-processing networks. The most consistent clinical benefits are reductions in anxiety, pain, selected medication consumption, and postoperative nausea and vomiting, particularly when hypnosis is combined with local anesthesia and light sedation. In contrast, effects on stress biomarkers, wound healing, gastrointestinal recovery, and length of stay remain unproven. Effects are heterogeneous, and virtual reality-delivered hypnosis has yielded inconsistent results. The novelty of this review lies in its evidence-calibrated positioning of hypnosis as an optional, individualized adjunct within multimodal anesthesia that separates established benefits from unsupported claims.