Definition
Narcoanalysis, also known as Abreactive Therapy, is a psychotherapeutic technique that involves administering sedative drugs to induce a semi-hypnotic or relaxed state in the patient. This state allows the therapist to explore repressed memories, emotions, or traumatic experiences that may be contributing to the patient’s mental health condition. The goal is to help the patient process and integrate these experiences into their personality in a healthier way
Purposes
- To ventilate the traumatic, painful experiences in therapeutic situations.
- To release the emotional conflicts and disturbances.
- To give positive suggestions and improve tolerance.
- To elicit suicidal or paranoid ideas from patient’s mind.
Indications
- Hysterical stupor.
- Catatonic stupor.
- Personality disorders.
- Post-traumatic stress disorders.
- Hysterical convulsions.
- Dissociative disorders.
- Acute anxiety.
- Phobias.
Contraindications
- Cardiac/renal/liver diseases.
- General disability.
- Severe anaemia.
- Mental retardation.
- Schizophrenia.
Articles
- Injection sodium pentothal-250-500 mg.
- Distilled water.
- Syringes and needles.
- Oxygen cylinder.
- AMBU bag.
- IV stand, IV fluid.
- K-basin.
- Suction apparatus.
- Emergency drugs.
Procedure
| Nursing Actions | Rationale | |
| 1. | Before procedure Explain procedure to the patient/relatives and obtain informed consent. | Legal implications are met and proper explanation helps to win patient’s confidence and trust. |
| 2. | Perform thorough physical examination. | Identifies any medical illness or contraindication. |
| 3. | Ensure that all laboratory investigations are done and reports are collected. | Helps to rule out any physical pathology. |
| 4. | Instruct the patient to be nil per oral (NPO), 4-6 hours prior to procedure. | Prevents complication due to anaesthetic effect. |
| 5. | Keep ready all emergency drugs, suction apparatus, oxygen, etc. | Helps to meet the emergency situation if it occurs. |
| 6. | Transfer the patient to treatment room. Ensure that he/she is comfortable in a bed. | Since patient goes to hypnotic state, it is preferable that the patients lies in a bed. |
| 7. | During procedure Administer injection pentothal sodium mixed with 20-40 ml of distilled water, intravenously till it produces a state of trance between wakefulness and sleep where patient is able to answer questions (Requires physician’s prescription). | |
| 8. | Ensure that patient has gone to ‘trance’ state. | Trance state is ideal so that patient will release his emotional conflicts and receives suggestions when given. |
| 9. | The therapist will ask questions that will encourage the patient to ventilate deep seated conflicts. | Helps to release patient’s pent-up emotions. |
| 10. | Encourage expression of emotions like crying, anger, fear, etc. | Helps to release patient’s pent-up emotions. |
| 11. | Record patient’s conversations. | |
| 12. | Monitor and record vital signs during procedure. | Evaluates patient’s condition. |
| 13. | Once the patient has fully verbalized emotional conflicts, the therapist can give positive suggestions. | Patient can take up suggestions easily in the ‘trance’ state. |
| 14. | Administer the remaining medications as per order. | Ensures rest and sleep after an emotionally charged situation. |
| 15. | After procedure Check vital signs every 30 minutes after procedure for 2 hours. | Helps to identify complications early. |
| 16. | Transfer the patient to his/her room. | |
| 17. | Monitor the patient. | Identifies post-anesthetic complications. |
| 18. | Give fluids or food when fully conscious and after gag reflex has returned. | Reduces risk of aspiration. |
| 19. | Record procedure and other findings in nurses’ record | Recording enables communication between staff members. |
Complications
- Aggression.
- Depression.
- Disorientation.
- Suicidal tendency.
- Anxiety.
Special considerations
- Obtain informed consent from the patient, explaining the risks, benefits, and purpose of the therapy.
- Ensure compliance with legal frameworks and institutional guidelines, especially when used in forensic or investigative contexts.
- Avoid using narcoanalysis in patients with conditions that may increase risks, such as severe cardiovascular or neurological disorders.
- Administer psychotropic drugs (e.g., sodium pentothal) under strict medical supervision.
- Monitor for adverse reactions, such as excessive sedation or respiratory distress.
- Ensure proper dosage and timing to achieve therapeutic effects while minimizing risks.
- Conduct the therapy in a controlled environment with emergency equipment readily available.
- Provide emotional reassurance to reduce patient anxiety before and after the therapy.
- Address any distressing memories or emotions that may arise during the session.
- Involve a team of professionals, including psychiatrists, anesthesiologists, and psychologists, to ensure comprehensive care.
- Collaborate with legal and forensic experts when therapy is used for investigative purposes.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- R.Sreevani, A Guide to Mental Health & Psychiatric Nursing, 6th Edition, 2024, Jaypee Publishers, ISBN 978-9366161686
- Sheila L. Videbeck, Psychiatric Nursing, Seventh Edition , 2017, Wolters Kluwer Publications, ISBN: 978- 1496355911
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JOHN NOORD
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