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January 10, 1986

Appropriateness of Hypnoanesthesia

JAMA. 1986;255(2):198. doi:10.1001/jama.1986.03370020040017

To the Editor.—  In their report of the use of hypnoanesthesia for the removal of a very large mass from the thigh of a morbidly obese woman, Morris et al1 state that their patient could not be managed safely by conventional anesthetic techniques and infer that the technique described, using hypnosis, fentanyl, and diazepam, was safe. I believe that both of those claims are subject to challenge.I agree with the authors that a regional anesthetic is the technique of choice in the morbidly obese patient undergoing surgery of the lower extremities. Their attempts at needle placement were unsuccessful, but those attempts are not described adequately, and leave the following questions: (1) How long a needle was available? It would be very unusual, even in the obese patient, to be unable to reach the lumbar epidural space with a 6-in Touhy needle. (2) Why was the patient unable to