Fake surgeries: does the placebo effect work in surgery?

benefits of the placebo effect It has been studied for hundreds of years. It is used both in scientific research to test the effectiveness of an experimental subject, and in the healthcare field. The latter is much less common. From an ethical point of view, its use is generally not recommended. However, in some cases it may be a good option compared to using certain medications. Now is it possible to do the same with surgical interventions?

Placebos are usually effective, especially when treating diseases or symptoms that may have some consequences. psychosomatic component. Although the brain mechanisms involved are not precisely known, it is thought that its effectiveness may be due to the release of neurotransmitters such as endorphins, capable of acting as an analgesic and inducing a feeling of well-being. It makes sense that a placebo cannot cure cancer or diabetes. And it doesn’t appear to be a substitute for surgery, since its effectiveness usually doesn’t depend on patients’ confidence in a cure.

However, in the 1990s, a scientist named Bruce Moseley showed that Placebo effect This may be helpful in a procedure known as knee arthroscopy. Later, other scientists did the same with many other surgical procedures. Perhaps there is some effectiveness. But can we be sure that this is a placebo effect?

History and benefits of the placebo effect

The placebo effect was first described by an English doctor John Haygarth. In that XVIII century Joint pain was usually treated by rolling a metal rod across the joint. Supposedly, its electromagnetic properties acted on the bodies of patients and relieved their pain. Haygarth wasn’t sure it would actually work, despite the good results he saw in his patients. Therefore, in 1799, he conceived a pioneering experiment.

He made wooden sticks that felt identical to the metal ones used to treat pain. He later used them on several patients with joint pain, without telling them whether they were using metal or wood. The results were almost the same when they were asked if they felt Less pain.

Since then, many other scientists have studied the power of placebos. It is logical that in the presence of pathology, priority is given to actual treatment. However, for people with psychosomatic symptoms, it can be a good alternative to unnecessary consumption of medications. Its usefulness has also been studied in Chronically ill, as a replacement for conventional treatment after a certain time. There are many ideas about this, but no one can say that the placebo effect works. In fact, this is the reason why there are so many pseudosciences that seem to be effective. Anyone who has felt calmer after taking a homeopathic remedy for anxiety has experienced the placebo effect on their own skin.

What about operations?

A arthroscopy This is a surgical procedure in which a metal tube is used to repair damaged cartilage in a joint. In addition, surgery is used to remove bone fragments that may be causing pain. All this under the influence of painkillers, of course.

Moseley had to carry out this intervention in 180 people with very severe knee pain, which even prevented them from getting out of their chairs. However, he decided to test whether a sham operation could be effective due to something similar to a placebo effect.

To achieve this, he performed conventional arthroscopy on half the patients, but developed a different procedure for the rest. After administration analgesicsThey made an incision in the knee similar to the one made to insert the tube, but nothing was inserted and no bone fragments were removed. Meanwhile, medical workers in the operating room imitated the movements and sounds of surgery.

These patients were followed for two years and it was found that there were no significant differences between the two groups in terms of either pain or motor ability. This supposed placebo seemed to work for them.

Since then, these types of interventions have begun to be performed as a replacement for others, not just arthroscopy. Placebos have been used in a variety of surgeries, from vertebroplasty installation of implants for treatment migraine. In these and other cases, the simulated intervention also worked.

It’s not really a placebo

Jeremy Howickfrom the University of Leicester, as described in the article for Talk that these simulated operations are not, in fact, driven by the placebo effect. If patients improve after intervention, this is not due to any physiological process associated with their condition. brain. Rather, it is because when confronted with cuts made in the operating room, the body initiates healing mechanisms that are also beneficial against the pathology or symptoms for which the operation is being performed.

For this reason, this scientist suggests that these operations should no longer be considered a form of placebo effect and should be renamed “Minimally invasive surgery”. This is just a matter of nomenclature, but perhaps it could help eliminate the ethical concerns that typically arise when performing these operations.

On the one hand, they avoid lying to patients. Howick explains that there were also studies done where they were informed about the type of intervention they were going to receive and It worked for them too.. This probably wouldn’t happen with a placebo. On the other hand, the fact that there is a physiological basis that has nothing to do with psychosomatics confirms that this is a real treatment that goes beyond placebo.

This isn’t commonly done at the moment, but perhaps we’ll see it more often in the future. It has benefits such as less risk of infection or complications after surgery. If it’s actually proven to work, why not give it a try?