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Carella M, Beck F, Quoilin C, Azongmo MM, Loheac A, Bonhomme VL, Vanhaudenhuyse A. Effect of virtual reality hypnosis on intraoperative sedation needs and functional recovery in knee arthroplasty: a prospective randomized clinical trial. Reg Anesth Pain Med 2024:rapm-2023-105261. [PMID: 38413184 DOI: 10.1136/rapm-2023-105261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/20/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND AND OBJECTIVES Perioperative psychological stress and pharmacological anxiolysis can negatively affect the quality of recovery after total knee arthroplasty. We aimed to assess whether hypnosis combined with virtual reality could reduce intraoperative pharmacological sedation and improve quality of recovery after total knee arthroplasty surgery. METHODS In this prospective randomized clinical trial, 60 patients scheduled for total knee arthroplasty with spinal anesthesia were randomly divided into 2 groups of 30 patients each. Intraoperatively, intermittent boluses of midazolam 1 mg were administered at 5 min intervals at the patient's request, with a maximum driven by the clinical assessment of sedation depth. During surgery, patients received standard care (group control) or virtual reality hypnosis (group VRH). An unblinded observer recorded the total dose of midazolam administered during surgery, and changes in the Quality-of-Recovery 15-item score, comfort, fatigue, pain and anxiety before and 1, 3 and 7 days after surgery. RESULTS Patients in the VRH group required a lower dose of midazolam (mg; median (range)) intraoperatively (group VRH: 0 (0-4) and group control: 2 (0-9), p<0.001). Quality-of-Recovery 15-item, anxiety, and pain were similar between groups. CONCLUSIONS In total knee arthroplasty with spinal anesthesia, VRH reduces the requirement for intraoperative pharmacological sedation, without a change in the quality of recovery. TRIAL REGISTRATION NUMBER NCT05707234.
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Affiliation(s)
- Michele Carella
- Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège, Liège, Belgium
- Inflammation and Enhanced Rehabilitation Laboratory (Regional Anesthesia and Analgesia), GIGA-I3 Thematic Unit, GIGA-Research, Liège University, Liège, Belgium
| | - Florian Beck
- Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège, Liège, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, GIGA Research, Liège University, Liège, Belgium
| | | | - Murielle M Azongmo
- Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Adrien Loheac
- Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Vincent L Bonhomme
- Department of Anesthesia and Intensive Care Medicine, Centre Hospitalier Universitaire de Liège, Liège, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, GIGA Research, Liège University, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Interdisciplinary Algology Center, Centre Hospitalier Universitaire de Liège, Liège, Belgium
- Sensation and Perception Research Group, GIGA-Consciousness, GIGA Research, Liège University, Liège, Belgium
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Catalano Chiuvé S, Momjian S, Wolff A, Corniola MV. Effectiveness and reliability of hypnosis in stereotaxy: a randomized study. Acta Neurochir (Wien) 2024; 166:112. [PMID: 38411747 PMCID: PMC10899299 DOI: 10.1007/s00701-024-05943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/04/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND Patients suffering from Parkinson's disease (PD) may experience pain during stereotactic frame (SF) fixation in deep brain stimulation (DBS). We assessed the role of hypnosis during the SF fixation in PD patients undergoing awake bilateral subthalamic nucleus (STN) DBS. METHODS N = 19 patients were included (N = 13 males, mean age 63 years; N = 10 allocated to the hypnosis and N = 9 allocated to the control groups). Patients were randomly assigned to the interventional (hypnosis and local anesthesia) or non-interventional (local anesthesia only) groups. The primary outcome was the pain perceived (the visual analogue scale (VAS)). Secondary outcomes were stress, anxiety, and depression, as measured by the perceived stress scale (PSS) and hospital anxiety and depression scale (HADS). Procedural distress was measured using the peritraumatic distress inventory (PDI-13). RESULTS In the hypnosis group, VASmean was 5.6 ± 2.1, versus 6.4 ± 1.2 in the control group (p = 0.31). Intervention and control groups reported similar VASmax scores (7.6 ± 2.1 versus 8.6 ± 1.6 (p = 0.28), respectively). Both groups had similar HADS scores (6.2 ± 4.3 versus 6.7 ± 1.92, p = 0.72 (HADSa) and 6.7 ± 4.2 versus 7.7 ± 3, p = 0.58 (HADSd)), so were the PSS scores (26.1 ± 6.3 versus 25.1 ± 7, p = 0.75). Evolutions of VASmean (R2 = 0.93, 95% CI [0.2245, 1.825], p = 0.03) and PDI-13 scores (R2 = 0.94, 95% CI [1.006, 6.279], p = 0.02) significantly differ over follow-up with patients in the hypnosis groups showing lower scores. CONCLUSION In this unblinded, randomized study, hypnosis does not influence pain, anxiety, and distress during awake SF fixation but modulates pain memory over time and may prevent the integration of awake painful procedures as a bad experience into the autobiographical memory of patients suffering from PD. A randomized controlled study with more data is necessary to confirm our findings.
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Affiliation(s)
- Sabina Catalano Chiuvé
- Neurology Department, Neuropsychology Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Shahan Momjian
- Faculty of Medicine, Université of Genève, Geneva, Suisse
- Neurosurgery Department, Geneva University Hospitals, Geneva, Switzerland
| | - Adriana Wolff
- Anesthesiology Department, Geneva University Hospitals, Geneva, Switzerland
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Tigges-Limmer K, Brocks Y, Winkler Y, Stock Gissendanner S, Gummert J. Clinical experience with medical hypnosis as an adjunctive therapy in heart surgery. Front Psychol 2024; 15:1356392. [PMID: 38440236 PMCID: PMC10910116 DOI: 10.3389/fpsyg.2024.1356392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/01/2024] [Indexed: 03/06/2024] Open
Abstract
Heart surgery patients are at high risk for psychological trauma and comorbid psychological disorders. Depression, anxiety, and post-traumatic stress disorders in this patient group are predictors of outcomes after cardiac surgery. Medical hypnosis is effective for non-pharmacologic prevention and treatment of psychological disorders and has been associated with improved health-related quality of life and better cardiovascular outcomes. This contribution makes note of evidence of the effectiveness of medical hypnosis in a discussion of the clinical experience with specific hypnotherapeutic tools and interventions from the perspective of the mental health team in one large cardiac center in Germany. Based on our experience, we encourage heart centers to educate their heart surgery care teams about the core concepts of medical hypnosis and to make hypnotherapeutic techniques available as an adjunctive therapy.
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Affiliation(s)
- Katharina Tigges-Limmer
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | - Yvonne Brocks
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | - Yvonne Winkler
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
| | | | - Jan Gummert
- Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr University, Bochum, Germany
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Geagea D, Ogez D, Kimble R, Tyack Z. Redefining hypnosis: A narrative review of theories to move towards an integrative model. Complement Ther Clin Pract 2024; 54:101826. [PMID: 38199053 DOI: 10.1016/j.ctcp.2023.101826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/14/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024]
Abstract
Hypnosis is an ancient mind-body intervention that has regained interest with the surge of research in the last decade documenting its clinical validity. Yet, theoretical controversies and misconceptions prevail among theorists, clinicians, and the general public, impeding the understanding, acceptance, replication, and use of hypnosis. Providing adequate information, which dispels misconceptions and promotes more balanced views, is warranted to facilitate the implementation and adoption of hypnosis in clinical and research settings. This review re-examines the conceptualisation of hypnosis throughout history and the theoretical controversies surrounding it while highlighting their meeting points and clinical implications. Despite dichotomies, a broad agreement appears across theoretical approaches regarding hypnotic analgesia effects, key components, and vocabulary. Further, theories highlight key factors of hypnotic responding. For instance, social theories highlight social and contextual variables, whereas state theories highlight biopsychosocial mechanisms and individual factors. Based on theories, the terms hypnotherapy or clinical hypnosis are recommended to refer to the therapeutic use of hypnosis in psychotherapeutic and medical contexts, respectively. This review concludes with a model that integrates various theories and evidence and presents hypnosis as a complex multifaceted intervention encompassing multiple procedures, phenomena, and influencing factors. This review intends to deepen our understanding of hypnosis, and promote its more rapid adoption and adequate implementation in research and clinical contexts, in addition to steering research towards evidence-based hypnotic practice. The review can have important research and clinical implications by contributing to advancing knowledge regarding hypnotic procedures, phenomena, and influencing factors.
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Affiliation(s)
- Dali Geagea
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.
| | - David Ogez
- Department of Anaesthesiology and Pain Medicine, University of Montreal, Montreal, Canada
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Hospital, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia; Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
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Rosendahl J, Alldredge CT, Haddenhorst A. Meta-analytic evidence on the efficacy of hypnosis for mental and somatic health issues: a 20-year perspective. Front Psychol 2024; 14:1330238. [PMID: 38268815 PMCID: PMC10807512 DOI: 10.3389/fpsyg.2023.1330238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/12/2023] [Indexed: 01/26/2024] Open
Abstract
Introduction Documented use and investigation of hypnosis spans centuries and its therapeutic use has received endorsement by multiple medical associations. We conducted a comprehensive overview of meta-analyses examining the efficacy of hypnosis to provide a foundational understanding of hypnosis in evidence-based healthcare, insight into the safety of hypnosis interventions, and identification of gaps in the current research literature. Methods In our systematic review, meta-analyses of randomized controlled trials on the efficacy of hypnosis in patients with mental or somatic health problems compared to any control condition published after the year 2000 were included. A comprehensive literature search using Medline, Scopus, PsycINFO, The Cochrane Library, HTA Database, Web of Science and a manual search was conducted to identify eligible reviews. Methodological quality of the included meta-analyses was rated using the AMSTAR 2 tool. Effect estimates on various outcomes including at least three comparisons (k ≥ 3) were extracted and transformed into a common effect size metric (Cohen's d). If available, information on the certainty of evidence for these outcomes (GRADE assessment) was obtained. Results We included 49 meta-analyses with 261 distinct primary studies. Most robust evidence was reported for hypnosis in patients undergoing medical procedures (12 reviews, 79 distinct primary studies) and in patients with pain (4 reviews, 65 primary studies). There was a considerable overlap of the primary studies across the meta-analyses. Only nine meta-analyses were rated to have high methodological quality. Reported effect sizes comparing hypnosis against control conditions ranged from d = -0.04 to d = 2.72. Of the reported effects, 25.4% were medium (d ≥ 0.5), and 28.8% were large (d ≥ 0.8). Discussion Our findings underline the potential of hypnosis to positively impact various mental and somatic treatment outcomes, with the largest effects found in patients experiencing pain, patients undergoing medical procedures, and in populations of children/adolescents. Future research should focus on the investigation of moderators of efficacy, on comparing hypnosis to established interventions, on the efficacy of hypnosis for children and adolescents, and on identifying patients who do not benefit from hypnosis. Clinical Trial Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023395514, identifier CRD42023395514.
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Affiliation(s)
- Jenny Rosendahl
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
| | - Cameron T. Alldredge
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, United States
| | - Antonia Haddenhorst
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany
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Wege M, von Blanckenburg P, Maier RF, Knoeppel C, Grunske A, Seifart C. Do parents get what they want during bad news delivery in NICU? J Perinat Med 2023; 51:1104-1111. [PMID: 37336635 DOI: 10.1515/jpm-2023-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/02/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVES Little is known about parents' preferences in breaking bad news (BBN) in neonatology. The study was aimed at comparing parents' experiences with their first BBN discussion with a neonatologist/pediatric surgeon to their personal preferences. METHODS We conducted a quantitative survey amongst 54 parents of hospitalized preterm or term infants with severe diseases in two medium-size and one small German neonatal units. Parents answered self-rated questions on how they perceived BBN during their infant's hospital stay, asking for procedure and perception of BBN, their preferences and satisfaction with BBN. RESULTS Overall satisfaction with BBN was moderate to high (median (min-max): 8 (1-10) on a 1-10-Likert scale). A compassionate way of disclosure correlated highest with overall satisfaction with BBN. Thorough transmission of information in an easy to understand manner emerged as another crucial point and correlated significantly to satisfaction with BBN, too. The study revealed that it was highly important for parents, that physicians had good knowledge of the infant and the course of his/her disease, which was only met in a minority of cases. Moreover, there was a major discrepancy between expected and observed professional competence of the delivering physicians. Additionally, physicians did not set aside sufficient time for BBN and parents reported a lack of transporting assurance and hope. CONCLUSIONS In BBN physicians should draw greatest attention to ensure understanding in parents, with good knowledge of child and disease and sufficient time in a trustworthy manner. Physicians should focus on transporting competence, trust and gentleness.
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Affiliation(s)
- Mirjam Wege
- Children's Hospital, University Hospital, Philipps University of Marburg, Marburg, Germany
| | - Pia von Blanckenburg
- Department of Clinical Psychology and Psychotherapy, Philipps University of Marburg, Marburg, Germany
| | - Rolf Felix Maier
- Children's Hospital, University Hospital, Philipps University of Marburg, Marburg, Germany
| | - Carmen Knoeppel
- Children's Hospital, Hospital Bad Hersfeld GmbH, Bad Hersfeld, Germany
| | | | - Carola Seifart
- Faculty of Medicine, Deans Office, Research Group Medical Ethics, Philipps University of Marburg, Marburg, Germany
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Karrasch S, Mavioğlu RN, Matits L, Gumpp AM, Mack M, Behnke A, Tumani V, Karabatsiakis A, Bongartz W, Kolassa IT. Randomized controlled trial investigating potential effects of relaxation on mitochondrial function in immune cells: A pilot experiment. Biol Psychol 2023; 183:108656. [PMID: 37544424 DOI: 10.1016/j.biopsycho.2023.108656] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/13/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
This study aimed to investigate the effect of a relaxation response induced by hypnosis on the mitochondrial energy production of immune cells compared to an everyday relaxing situation. Chronically stressed individuals (88% women) with at least moderate suggestibility were randomized to a hypnosis (20 min relaxation hypnosis; n = 20) or a control condition (20 min documentary; n = 22). Before and after intervention, peripheral blood was collected. The primary outcomes were mitochondrial respiration and density in immune cells measured by high-resolution respirometry and citrate synthase activity assays. As secondary outcome, perceived stress, anxiety, and depressive mood were assessed. The intervention led to no significant Group × Time effects on mitochondrial bioenergetic parameters but a significant Time effect (ηp2 = .09 -.10). Thus, there were no differences in the experimental conditions concerning the measured parameters of mitochondrial bioenergetics. Exploratory subanalyses indicated that stress, anxiety, and depressive mood were linked to lower mitochondrial respiration. Individuals with higher anxiety had less decrease in routine respiration over time than those with lower anxiety (ηp2 = .09). This study explores the effects of relaxation in the form of hypnosis compared to watching a video on the energy metabolism of immune cells. Relaxation, whether in targeted (hypnosis) or untargeted (documentary) form, affected mitochondrial respiration. Further research should focus on the long-term effects of relaxation on bioenergetics. The trial was retrospectively registered on 07/12/2021, DRKS00027356, https://drks.de/search/de/trial/DRKS00027356.
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Affiliation(s)
- Sarah Karrasch
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
| | - Rezan Nehir Mavioğlu
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lynn Matits
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany; Division of Sports and Rehabilitation Medicine, Department of Medicine, Ulm University Hospital, Leimgrubenweg 14, D-89075 Ulm, Germany
| | - Anja Maria Gumpp
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Matthias Mack
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Visal Tumani
- Department of Psychiatry and Psychotherapy III, Ulm University, Leimgrubenweg 12, D-89075 Ulm, Germany
| | - Alexander Karabatsiakis
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany; Institute of Psychology, Department of Clinical Psychology-II, University of Innsbruck, Universitätsstrasse 57, A-6020 Innsbruck, Austria
| | - Walter Bongartz
- Klingenberg Institute of Clinical Hypnosis, Färberstr. 3a, D-78467 Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
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Gelse N, Bodschwinna D, Jarczok MN, Wanner M, Volz M, Mayer-Steinacker R, Huober J, Gündel H, Hönig K. Enhancing coping skills through brief interventions during cancer therapy - a quasi-experimental clinical pilot study. Front Psychol 2023; 14:1253423. [PMID: 37744600 PMCID: PMC10513768 DOI: 10.3389/fpsyg.2023.1253423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
IntroductionPsycho-oncological interventions can reduce distress by activating individual resources and enhancing coping skills. Since medical cancer treatment is performed increasingly in outpatient settings, there is a growing need for evidence-based and brief interventions to be integrated seamlessly into these treatment procedures. The aim of the present pilot study is to examine the feasibility of brief interventions to cope with illness in this area.MethodsA single center quasi-experimental design was developed in oncological outpatients at the University Medical Center Ulm, Germany, including N = 60 individuals with cancer undergoing chemotherapy or immunotherapy. The intervention group (IG) consisted of N = 40 participants. These were assigned to either cognitive behavioral interventions (CBI) or hypnotherapeutic interventions (HTI). The interventions each comprised three individual one-hour sessions. In addition, a waiting control group (WCG of N = 20) was set up, receiving care-as-usual. Primary outcomes were feasibility measures such as recruitment rates, participant retention rates, and complete data rates. Clinical results were discussed for the feasibility of a comprehensive efficacy study.ResultsThe recruitment and completion rates illustrate demand and acceptance of the offer. Of the 208 individuals with cancer offered to participate in the study, 77 were interested in enrolling. This rate of 37% roughly corresponds to the use of psycho-oncological services in general. 17 individuals (22%) withdraw from participation before the intervention began due to severe deterioration in their disease. Once started, all 40 individuals of the IG (100%) completed the intervention, and 17 individuals of the WCG (85%) completed the accompanying questionnaires. Tentative results on clinical outcomes indicate that brief interventions on resource activation could have lasting effects on well-being and stress management.DiscussionWith this feasibility study, we aimed to explore the potential of brief interventions such as hypnotherapeutic and cognitive-behavioral approaches in psycho-oncology as an integral part of oncology day care. Even with a small number of participants results seem to indicate that the study design and brief interventions such as those presented can offer a low-threshold service that can be seamlessly integrated into oncological therapy. Given the promising results of this pilot study, we propose a full RCT on the effectiveness of such a brief intervention program.Clinical trial registrationhttps://www.drks.de, German Trials Register (DRKS00019095).
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Affiliation(s)
- Norbert Gelse
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Daniela Bodschwinna
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
| | - Marc N. Jarczok
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Magdalena Wanner
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Madeleine Volz
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Regine Mayer-Steinacker
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
- Department of Internal Medicine III, University Ulm Medical Center, Ulm, Germany
| | - Jens Huober
- Department of Gynecology and Obstetrics, University Ulm Medical Center, Ulm, Germany
- Cantonal Hospital, Breast Center St. Gallen, St. Gallen, Switzerland
| | - Harald Gündel
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
| | - Klaus Hönig
- Department of Psychosomatic Medicine and Psychotherapy, University Ulm Medical Center, Ulm, Germany
- Comprehensive Cancer Center Ulm, University Ulm Medical Center, Ulm, Germany
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Geagea D, Tyack Z, Kimble R, Polito V, Ayoub B, Terhune DB, Griffin B. Clinical Hypnosis for Procedural Pain and Distress in Children: A Scoping Review. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:661-702. [PMID: 36448690 PMCID: PMC10233484 DOI: 10.1093/pm/pnac186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Pain and distress are common in children undergoing medical procedures, exposing them to acute and chronic biopsychosocial impairments if inadequately treated. Clinical hypnosis has emerged as a potentially beneficial treatment for children's procedural pain and distress due to evidence of effectiveness and potential superiority to other psychological interventions. However, systematic reviews of clinical hypnosis for children's procedural pain and distress have been predominantly conducted in children undergoing oncology and needle procedures and are lacking in broader pediatric contexts. This scoping review maps the evidence of clinical hypnosis for children's procedural pain and distress across broad pediatric contexts while highlighting knowledge gaps and areas requiring further investigation. METHODS Published databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus, and Web of Science) and grey literature were searched in addition to hand-searching reference lists and key journals (up to May 2022). Two independent reviewers screened the titles and abstracts of search results followed by a full-text review against eligibility criteria. Articles were included if they involved a clinical hypnosis intervention comprising an induction followed by therapeutic suggestions for pain and distress in children undergoing medical procedures. This review followed the Arksey and O'Malley (2005) methodology and incorporated additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses. RESULTS A total of 38 eligible studies involving 2,205 children were included after 4,775 articles were screened. Research on clinical hypnosis for children's procedural pain and distress was marked by a lack of fidelity measures and qualitative data as well as by inadequate intervention reporting and high attrition rates. Evidence regarding the safety of clinical hypnosis, pain unpleasantness outcomes, factors influencing outcomes, as well as barriers and facilitators to implementing hypnosis and study procedures was also lacking. Clinical hypnosis has potential benefits for children's procedural pain and distress based on evidence of superiority to control conditions and nonpharmacological interventions (e.g., distraction, acupressure) with moderate to large effect sizes as reported in 76% of studies. However, heterogeneous interventions, contexts, study designs, and populations were identified, and the certainty of the evidence was not evaluated. CONCLUSIONS The review suggests potential benefits of clinical hypnosis for children's procedural pain and distress and thus provides a precursor for further systematic reviews and trials investigating the effectiveness of clinical hypnosis. The review also indicates the need to further explore the feasibility, acceptability, implementation, and safety of clinical hypnosis in children undergoing painful procedures. Based on the review, researchers implementing clinical hypnosis should adequately report interventions or use treatment manuals, follow recommended research guidelines, and assess the fidelity of intervention delivery to promote replicating and comparing interventions. The review also highlights common methodological shortcomings of published trials to avoid, such as the lack of implementation frameworks, small sample sizes, inadequate reporting of standard care or control conditions, and limited evidence on pain unpleasantness outcomes.
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Affiliation(s)
- Dali Geagea
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Child Health Research Centre, Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia
- Australian Centre for Health Service Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Queensland Children's Hospital, The University of Queensland, Brisbane, Australia
| | - Vince Polito
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Bassel Ayoub
- Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - Devin B Terhune
- Department of Psychology, Goldsmiths University of London, London, UK
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Bronwyn Griffin
- School of Nursing and Midwifery, Griffith University, Nathan, Queensland, Australia
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Wawrziczny E, Picard S, Buquet A, Traversac E, Puisieux F, Pasquier F, Huvent-Grelle D, Doba K. Hypnosis Intervention for Couples Confronted with Alzheimer’s Disease: Promising Results of a First Exploratory Study. J Alzheimers Dis 2022; 89:1351-1366. [DOI: 10.3233/jad-220430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Dementia has a negative impact on the quality of life of the person with dementia and their spouse caregivers, as well as on the couple’s relationship, which can lead to high levels of distress for both partners. Hypnosis has been shown to be effective in managing distress and increasing the quality of the relationship. Objective: The aim was to develop a standardized hypnosis intervention for couples confronted with Alzheimer’s disease and evaluate its feasibility, acceptability, and helpfulness in managing the distress of both partners and increasing the quality of the relationship. Methods: In a single-arm study, sixteen couples received the 8-week intervention. Qualitative and quantitative assessments were conducted pre- and post-intervention as well as three months after. Results: 88.9% of couples (n = 16) of the final sample (n = 18) completed the intervention. Despite the negative representations of hypnosis, several factors led couples to accept to participate in this study: positive expectations, professional endorsement, medical application, non-drug approach, home-based, free, flexible, and couple-based intervention. The results showed a significant decrease in distress for both partners. These effects were maintained three months after the intervention. Couples felt more relaxed, had fewer negative emotions, accepted difficulties more easily, were more patient, and reported better communication and more affection in the relationship. Conclusion: Overall, this pilot study shows the feasibility and acceptability of hypnosis with couples confronted with Alzheimer’s disease. Although measures of the preliminary pre- and post-intervention effects are encouraging, confirmatory testing with a randomized controlled trial is needed.
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Affiliation(s)
- Emilie Wawrziczny
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - Sandrine Picard
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - Amandine Buquet
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - Elodie Traversac
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
| | - François Puisieux
- Department of Geriatrics, Memory consultation, CHU Lille, Lille, France
| | - Florence Pasquier
- Department of Neurology, Memory Research and Resources Clinic, CHU Lille, Lille, France
| | | | - Karyn Doba
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d’Ascq, France
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11
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Baussard L, Cousson-Gélie F, Jarlier M, Charbonnier E, Le Vigouroux S, Montalescot L, Janiszewski C, Fourchon M, Coutant L, Guerdoux E, Portales F. Hypnosis and cognitive behavioral therapy with online sessions to reduce fatigue in patients undergoing chemotherapy for a metastatic colorectal cancer: Rational and study protocol for a feasibility study. Front Psychol 2022; 13:953711. [PMID: 35967617 PMCID: PMC9363840 DOI: 10.3389/fpsyg.2022.953711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background In metastatic colorectal cancer (CRCm), fatigue is pervasive, reduces quality of life, and is negatively associated with survival. Its course is explained in part by psychosocial variables such as emotional distress, coping strategies, or perceived control. Thus, to reduce fatigue, psychosocial interventions appear to be relevant. In some cancers, Cognitive Behavioral Therapies (CBT) reduce fatigue. Hypnosis is also used as a complementary therapy to reduce the side effects of cancer. While CBT requires specific training often reserved for psychologists, hypnosis has the advantage of being increasingly practiced by caregivers and is therefore less expensive (Montgomery et al., 2007). On the other hand, CBT and hypnosis remain understudied in the CRC, do not focus on the symptom of fatigue and in Europe such programs have never been evaluated. Objectives Implementing an intervention in a healthcare setting is complex (e.g., economic and practical aspects) and recruiting participants can be challenging. The primary objective will therefore be to study the feasibility of two standardized interventions (hypnosis and CBT) that aim to reduce fatigue in patients with CRCm treated in a French cancer center. Methods and design A prospective, single-center, randomized interventional feasibility study, using mixed methods (both quantitative and qualitative). A total of 60 patients will be allocated to each intervention group [Hypnosis (n = 30) and CBT (n = 30)]. Participants will be randomized into two parallel groups (ratio 1:1). Both programs will consist of 6 weekly sessions focusing on the CRF management over a period of 6 weeks. Trained therapists will conduct the program combining 3 face-to-face sessions and 3 online sessions. The feasibility and experience of interventions will be evaluated by the outcome variables, including the adhesion rate, the reasons for acceptability, relevance or non-adherence, the satisfaction, the fatigue evolution (with ecological momentary assessments), and the quality of life. All questionnaires will be self-assessment using an online application from the cancer center. Discussion Results will highlight the barriers/facilitators to the implementation of the program and the relevance of the program to the patients, and will be used to generate hypotheses for a randomized control trial. Clinical trial registration ClinicalTrials.gov Identifier: NCT04999306; https://clinicaltrials.gov/ct2/show/NCT04999306.
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Affiliation(s)
- Louise Baussard
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
- *Correspondence: Louise Baussard
| | - Florence Cousson-Gélie
- Université Paul Valéry Montpellier 3, Laboratoire Epsylon EA4556, Languedoc-Roussillon, France
| | - Marta Jarlier
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
| | - Elodie Charbonnier
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Sarah Le Vigouroux
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Lucile Montalescot
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Chloé Janiszewski
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
| | - Michele Fourchon
- UNIV. NIMES, APSY-V, F-30021 Nîmes Cedex 1, Languedoc-Roussillon, France
| | - Louise Coutant
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
| | - Estelle Guerdoux
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
- Institut Desbrest d'Epidémiologie et de Santé Publique, INSERM, Université de Montpellier, Languedoc-Roussillon, France
| | - Fabienne Portales
- Institut du Cancer de Montpellier – Université de Montpellier, Languedoc-Roussillon, France
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12
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Montgomery GH, Kirsch I. The Proposed Task Force Hypnosis Efficacy Guidelines: The Role of Moderation and Mediation in Efficacy Trials. Int J Clin Exp Hypn 2022; 70:213-219. [PMID: 35913676 PMCID: PMC9420796 DOI: 10.1080/00207144.2022.2104647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Hypnosis interventions have too often failed to disseminate, in part because of the relatively few high-quality, randomized clinical trials. The Task Force proposes efficacy guidelines, which are intended to improve the quality of clinical hypnosis research and thereby increase dissemination of beneficial hypnosis interventions. However, the Task Force, in muddying the focus on efficacy with opinions about moderation and mediation, proposes guidelines that are likely to: (1) weaken efficacy findings; (2) increase participant mistrust; (3) make efficacy trials more cumbersome; and, (4) treat hypnosis as though it were something other than a time-honored form of talk therapy. While applauding the Task Force's intentions, the current recommendations could be changed to better accomplish their goal of increasing hypnosis dissemination and implementation.
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Affiliation(s)
- Guy H Montgomery
- Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai, New York City, USA
| | - Irving Kirsch
- Program in Placebo Studies, Harvard Medical School, Boston, Massachusetts, USA
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13
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Geagea D, Griffin B, Kimble R, Polito V, Terhune DB, Tyack Z. Hypnotherapy for procedural pain, itch, and state anxiety in children with acute burns: a feasibility and acceptability study protocol. Pilot Feasibility Stud 2022; 8:58. [PMID: 35264248 PMCID: PMC8905723 DOI: 10.1186/s40814-022-01017-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background Burns and related procedures are painful and distressing for children, exposing them to acute and chronic sequelae that can negatively affect their physiological, psychological, and social functions. Non-pharmacological interventions such as distraction techniques are beneficial adjuncts to pharmacological agents for procedural pain, state anxiety, and itch in children with burns but have limitations (e.g. lack of research on burn-related itch, tailoring, and consensus on optimal treatment). Hypnotherapy is a non-pharmacological intervention that can be tailored for varied settings and populations with evidence of benefit for itch and superior effectiveness in comparison to other non-pharmacological interventions for children’s procedural pain and state anxiety. Thus, children with burns can benefit from hypnotherapy as an adjunct to pharmacological agents. Yet, in paediatric burns, rigorous studies of effectiveness are limited and no studies have been identified that screen for hypnotic suggestibility, an important predictor of hypnotherapy outcomes. Considering potential barriers to the delivery of hypnotherapy in paediatric burns, the proposed study will examine the feasibility and acceptability of hypnotic suggestibility screening followed by hypnotherapy for procedural pain, state anxiety, and itch in children with acute burns. Methods An observational mixed-methods feasibility and acceptability study will be conducted over 15 weeks. Eligible children (N = 30) aged 4 to 16 years presenting to a paediatric burns outpatient centre in a metropolitan children’s hospital in Australia with acute burns requiring dressing changes will be included. Eligible parents of children (N = up to 30) and clinicians who perform dressing changes (N = up to 20) will also be included. Child participants screened as having medium to high suggestibility as assessed by behavioural measures will receive hypnotherapy during dressing changes. A process evaluation will target feasibility and acceptability as primary outcomes and implementation (i.e. fidelity in delivery), reach, potential effectiveness, and adoption of evaluation procedures and intervention as secondary outcomes. Discussion Ethical approval was obtained from the Queensland Children’s Hospital and Health Service ethics committee. Results will be published in peer-reviewed publications and conference proceedings. The findings will guide the design of future trials on the effectiveness of hypnotherapy and inform the development of child-centred hypnotic interventions in children with burns. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12620000988954 Supplementary Information The online version contains supplementary material available at 10.1186/s40814-022-01017-z.
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Affiliation(s)
- Dali Geagea
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia. .,Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4067, Australia.
| | - Bronwyn Griffin
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.,Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, 4058, Australia.,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, 4101, Australia
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4067, Australia.,Faculty of Health, School of Nursing, Queensland University of Technology, Kelvin Grove, QLD, 4058, Australia.,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, 4101, Australia
| | - Vince Polito
- School of Psychological Sciences, Macquarie University, Macquarie Park, NSW, 2109, Australia
| | - Devin B Terhune
- Department of Psychology, Goldsmiths University of London, London, SE14 6NW, UK
| | - Zephanie Tyack
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Level 7, 62 Graham Street, South Brisbane, QLD, 4101, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4067, Australia.,Australian Centre for Health Services Innovation (AusHSI) and Centre for Healthcare Transformation, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
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14
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Superiority of non-opioid postoperative pain management after thyroid and parathyroid operations: A systematic review and meta-analysis. Surg Oncol 2022; 41:101731. [DOI: 10.1016/j.suronc.2022.101731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 01/24/2022] [Accepted: 02/22/2022] [Indexed: 11/20/2022]
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15
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Rousseaux F, Dardenne N, Massion PB, Ledoux D, Bicego A, Donneau AF, Faymonville ME, Nyssen AS, Vanhaudenhuyse A. Virtual reality and hypnosis for anxiety and pain management in intensive care units: A prospective randomised trial among cardiac surgery patients. Eur J Anaesthesiol 2022; 39:58-66. [PMID: 34783683 PMCID: PMC8654253 DOI: 10.1097/eja.0000000000001633] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Virtual reality and hypnosis are little studied in complex contexts, such as intensive care, where patients need significant physical and psychological assistance. OBJECTIVES To compare and combine hypnosis and virtual reality benefits on anxiety and pain on patients before and after cardiac surgery. DESIGN Prospective randomised controlled clinical trial. SETTING The study was conducted in the University Hospital of Liege (Belgium) from October 2018 to January 2020. PATIENTS One hundred patients (66 ± 11.5 years; 24 women, 76 men) were included. Participants were adults undergoing cardiac surgery. Exclusion criteria: psychiatric diseases, claustrophobia, acrophobia, hearing loss, visual impairment, extreme fatigue, confusion surgery cancelled. INTERVENTIONS Patients were randomly assigned to four arms (control; hypnosis; virtual reality; virtual reality hypnosis) and had 20 min of one of the techniques the day before and the day after surgery. MAIN OUTCOMES MEASURES Anxiety, pain, fatigue, relaxation, physiological parameters, and opioid use were evaluated before and after each session. RESULTS The main results did not show any significant differences between the groups. In all groups, anxiety decreased and pain increased from baseline to the postoperative day. Relaxation increased in all groups in the pre-operative (P < 0.0001) and postoperative period (P = 0.03). There were no significant differences for fatigue, physiological measures, or opioid use. CONCLUSION As there were no significant differences between groups for the measured variables, we cannot affirm that one technique is better than another. Additional studies are required to compare and evaluate the cost-effectiveness of these techniques for critical care patients and caregivers. TRIAL REGISTRATION ClinicalTrials.gov: NCT03820700. https://clinicaltrials.gov/ct2/show/NCT03820700. Retrospectively registered on 29 January 2019.
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Affiliation(s)
- Floriane Rousseaux
- From the Laboratory of Cognitive Ergonomics and Work Intervention, University of Liege, ULiege (B32), Quartier Agora - Place des Orateurs (FR, AB, ASN), Algology Department, University Hospital of Liege, CHU Sart Tilman, Domaine Universitaire du Sart Tilman (MEF, AV), Sensation & Perception Research Group, GIGA Consciousness, University of Liege, GIGA (B34) (FR, AB, MEF, ASN, AV), Intensive Care Units, University Hospital of Liege (B35) (PBM, DL), Public Health Department, Biostatistics, University of Liege, CHU (B35) (ND, AFD) and Anesthesia & Intensive care, GIGA Consciousness, University of Liege, GIGA (B34), Quartier Hopital - Avenue de l'Hopital, Liege, Belgium (DL)
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16
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Geagea D, Tyack Z, Kimble R, Eriksson L, Polito V, Griffin B. Hypnotherapy for Procedural Pain and Distress in Children: A Scoping Review Protocol. PAIN MEDICINE (MALDEN, MASS.) 2021; 22:2818-2826. [PMID: 33528510 PMCID: PMC8665999 DOI: 10.1093/pm/pnab038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Inadequately treated pain and distress elicited by medical procedures can put children at higher risk of acute and chronic biopsychosocial sequelae. Children can benefit from hypnotherapy, a psychologically tailored intervention, as an adjunct to pharmacological agents to address the multiple components of pain and distress. Despite providing evidence on the effectiveness and potential superiority of hypnotherapy to other psychological interventions, research on hypnotherapy for pediatric procedural pain and distress has been predominantly limited to oncology and needle procedures. Plus, there is a lack of reporting of intervention manuals, factors influencing hypnotic responding, pain unpleasantness outcomes, theoretical frameworks, adverse events, as well as barriers and facilitators to the feasibility of delivering the intervention and study procedures. The proposed review aims to map the range and nature of the evidence on hypnotherapy for procedural pain and distress in children to identify gaps in literature and areas requiring further investigation. METHODS This review will follow the Arksey and O'Malley (2005) methodology and incorporate additional scoping review recommendations by the Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses. Relevant studies will be identified through searching published literature databases (PubMed, Cochrane Library, PsycINFO, Embase, CINAHL, Scopus and Web of Science) and grey literature in addition to hand-searching of reference lists and key journals. Two authors will independently screen titles and abstracts of search results followed by full-texts review against eligibility criteria. CONCLUSION Findings are anticipated to guide future research and inform the development of tailored hypnotic interventions in children.
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Affiliation(s)
- Daly Geagea
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Zephanie Tyack
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Roy Kimble
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
| | - Lars Eriksson
- Herston Health Sciences Library, The University of Queensland, Brisbane, Australia
| | - Vince Polito
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Bronwyn Griffin
- Centre for Children’s Burns and Trauma Research, The University of Queensland, Brisbane, Australia
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17
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Sine H, Achbani A, Filali K. The Effect of Hypnosis on the Intensity of Pain and Anxiety in Cancer Patients: A Systematic Review of Controlled Experimental Trials. Cancer Invest 2021; 40:235-253. [PMID: 34698595 DOI: 10.1080/07357907.2021.1998520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Pain is a common symptom in cancer patients. Hypnosis is considered one of the most recognized non-pharmacological techniques in pain management. In oncology, this technique can be used as a complementary treatment to reduce the level of pain and anxiety. The objective of this study is to systematically review and evaluate controlled clinical trials (CCTs) examining the effect of hypnosis on the intensity of pain, and anxiety in cancer patients. METHODS A systematic review was conducted according to the recommendations of the "Preferred reporting items for systematic reviews and meta-analyses" (PRISMA). The Cochrane systematic review database, the abstract databases, Scopus, PubMed, Google Scholar, and Cochrane Library have been systematically reviewed from 2005 to 2018. RESULTS Eleven CCT with a total of 1182 participants met the inclusion criteria and were included in this review. The participants were mainly women (n = 968). Their average age alternates between 48 and 58 years. Perceived pain was measured primarily by visual analog scale (VAS)/numerical pain rating scale (NPRS), which showed that anxiety was measured by Hospital Anxiety and Depression scale (HADS). Hypnosis-related anxiety and pain decreased significantly with respect to usual treatment. CONCLUSIONS Evidence suggests promising results of hypnosis on the management of pain, and anxiety levels in the vast majority of cancer patients. Therefore, because of the exploratory design and high risk of bias, the effectiveness of hypnosis or hypnotherapy in reducing pain and anxiety levels remains unclear. There is a need for more rigorous randomized controlled trials (RCTs).
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Affiliation(s)
- Hayat Sine
- Clinical Epidemiology and Medico-Surgical Sciences, Faculty of Medicine and Pharmacy, Mohammed V-Rabat University, Rabat, Morocco
| | - Abderrahmane Achbani
- Department of Biology, Faculty of Sciences, Laboratory of Cell Biology and Molecular Genetics, University Ibn Zohr, Agadir, Morocco.,Higher Institute of Nursing Professions and Health Techniques, Marrakech, Morocco
| | - Karim Filali
- Clinical Epidemiology and Medico-Surgical Sciences, Faculty of Medicine and Pharmacy, Mohammed V-Rabat University, Rabat, Morocco
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18
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Császár N, Scholkmann F, Bókkon I. Implications on hypnotherapy: Neuroplasticity, epigenetics and pain. Neurosci Biobehav Rev 2021; 131:755-764. [PMID: 34619172 DOI: 10.1016/j.neubiorev.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/07/2021] [Accepted: 10/01/2021] [Indexed: 01/11/2023]
Abstract
We provide a brief review about the significance of hypnosis with respect to applications and physiological processes in hypnotherapy. Our review concludes that hypnosis is a promising method to manage acute and chronic pain. In addition, we discuss indications pointing toward the view that hypnosis can induce changes in neuroplasticity possibly involving epigenetic mechanisms.
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Affiliation(s)
- N Császár
- National University of Public Services, Budapest, Hungary; Psychosomatic Outpatient Clinics, Budapest, Hungary.
| | - F Scholkmann
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, Switzerland.
| | - I Bókkon
- Psychosomatic Outpatient Clinics, Budapest, Hungary; Vision Research Institute, Neuroscience and Consciousness Research Department, Lowell, MA, USA.
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19
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Soriano AJ, Schnur JB, Harvie HS, Newman DK, Montgomery GH, Arya LA. Pilot randomized controlled trial of a hypnosis intervention for women with bladder pain syndrome. Neurourol Urodyn 2021; 40:1945-1954. [PMID: 34420228 DOI: 10.1002/nau.24771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/06/2021] [Accepted: 06/28/2021] [Indexed: 11/11/2022]
Abstract
AIMS To evaluate the feasibility and acceptability of a randomized controlled trial of a hypnosis intervention for the treatment of bladder pain syndrome/interstitial cystitis (BPS/IC) in women. METHODS We conducted a parallel arm, non-blinded, pilot randomized controlled trial of standardized hypnosis sessions including a hypnosis web tool versus usual care in adult women with BPS/IC. Pilot study outcomes included feasibility domains: process, resources and management, safety, and acceptability. Clinical outcomes of lower urinary tract symptoms and quality of life were measured using validated questionnaires at baseline and at the end of the 4-week intervention. RESULTS We randomized 29 out of 30 (96.7%) eligible women. In the hypnosis group, 12 of 15 (80.0%) subjects completed the 4-week intervention and follow up, and 13 of 14 (92.9%) in the usual care group. In the hypnosis group, adherence to the standardized sessions was 80% and participants used the web-based tool for an average of 5.6 ± 2.7 times per week. Scores for emotional distress, relaxation, pain severity and expected bladder symptoms significantly improved during the first two of three planned hypnosis sessions (all p < 0.05). Improvement in quality of life scores was greater in the hypnosis group than the usual care group (-2.6 ± 2.3 vs. -0.9 ± 1.1, p = 0.04). There were no significant between-group differences in urinary symptoms or bladder pain. No adverse events were reported. CONCLUSIONS A hypnosis intervention for the treatment of bladder pain syndrome/interstitial cystitis is feasible, acceptable, safe, and may improve quality of life.
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Affiliation(s)
- Alex J Soriano
- Division of Urogynecology, Department of Obstetrics and Gynecology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Julie B Schnur
- Department of Oncological Services, Ichan School of Medicine at Mount Sinai, Mount Sinai, New York, USA
| | - Heidi S Harvie
- Division of Urogynecology, Department of Obstetrics and Gynecology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Diane K Newman
- Division of Urology, Department of Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Guy H Montgomery
- Department of Oncological Services, Ichan School of Medicine at Mount Sinai, Mount Sinai, New York, USA
| | - Lily A Arya
- Division of Urogynecology, Department of Obstetrics and Gynecology, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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20
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Effect of Hypnosis on Anxiety: Results from a Randomized Controlled Trial with Women in Postmenopause. J Clin Psychol Med Settings 2021; 28:868-881. [PMID: 34403019 DOI: 10.1007/s10880-021-09810-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 01/27/2023]
Abstract
Anxiety is common, yet often under-treated, among women in postmenopause. This study examined the effect of a hypnotic intervention designed to reduce hot flashes, on anxiety levels of postmenopausal women. Anxiety was assessed using the State-Trait Anxiety Inventory, the Hospital Anxiety and Depression Scale-Anxiety subscale, and a visual analog scale. Additionally, hypnotizability was tested as a moderator of anxiety reductions. Significant reductions in anxiety were found from baseline to endpoint and follow-up and hypnosis was superior to the control condition. Additionally, ratings of Current Anxiety decreased from pre-session to post-session at each weekly visit and the pre-session scores reduced continuously. Hypnotizability was found to moderate anxiety reductions, but regardless of hypnotizability level participants, on average, experienced significant symptom improvement from baseline scores. These data provide initial support for the use of hypnosis to reduce symptoms of anxiety among postmenopausal women.Trial registration: This study was registered at ClinicalTrials.gov on February 11, 2011 under Identifier number NCT01293695 ( https://clinicaltrials.gov/ct2/show/NCT01293695?term=Elkins&cond=hot+flashes&draw=2&rank=2 ).
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21
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Gorsky K, Black ND, Niazi A, Saripella A, Englesakis M, Leroux T, Chung F, Niazi AU. Psychological interventions to reduce postoperative pain and opioid consumption: a narrative review of literature. Reg Anesth Pain Med 2021; 46:893-903. [PMID: 34035150 DOI: 10.1136/rapm-2020-102434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/13/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Evidence suggests that over half of patients undergoing surgical procedures suffer from poorly controlled postoperative pain. In the context of an opioid epidemic, novel strategies for ameliorating postoperative pain and reducing opioid consumption are essential. Psychological interventions defined as strategies targeted towards reducing stress, anxiety, negative emotions and depression via education, therapy, behavioral modification and relaxation techniques are an emerging approach towards these endpoints. OBJECTIVE This review explores the efficacy of psychological interventions for reducing postoperative pain and opioid use in the acute postoperative period. EVIDENCE REVIEW An extensive literature search was conducted in MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Medline In-Process/ePubs, Embase, Ovid Emcare Nursing, and PsycINFO, Web of Science (Clarivate), PubMed-NOT-Medline (NLM), CINAHL and ERIC, and two trials registries, ClinicalTrials.Gov (NIH) and WHO ICTRP. Included studies were limited to those investigating adult human subjects, and those published in English. FINDINGS Three distinct forms of psychological interventions were identified: relaxation, psychoeducation and behavioral modification therapy. Study results showed a reduction in both postoperative opioid use and pain scores (n=5), reduction in postoperative opioid use (n=3), reduction in postoperative pain (n=5), no significant reduction in pain or opioid use (n=7), increase in postoperative opioid use (n=1) and an increase in postoperative pain (n=1). CONCLUSION Some preoperative psychological interventions can reduce pain scores and opioid consumption in the acute postoperative period; however, there is a clear need to strengthen the evidence for these interventions. The optimal technique, strategies, timing and interface requires further investigation.
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Affiliation(s)
- Kevin Gorsky
- Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - Nick D Black
- Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK
| | - Ayan Niazi
- Department of Biology, Trent University, Peterborough, Ontario, Canada
| | - Aparna Saripella
- Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - Marina Englesakis
- Library & Information Services, University Health Network, Toronto, Ontario, Canada
| | - Timothy Leroux
- The Arthritis Program, University Health Network, Toronto, Ontario, Canada
| | - Frances Chung
- Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ahtsham U Niazi
- Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
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Lee A, Moulton D, Mckernan L, Russell A, Slaughter JC, Acra S, Walker L. Clinical Hypnosis in Pediatric Crohn's Disease: A Randomized Controlled Pilot Study. J Pediatr Gastroenterol Nutr 2021; 72:e63-e70. [PMID: 33538413 DOI: 10.1097/mpg.0000000000002980] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The aim of this study was to implement clinical hypnosis (CH) as an adjunctive therapy for adolescents with Crohn's disease (CD) and to assess the impact of CH on quality of life (QoL), abdominal pain, psychosocial measures, and disease activity compared with standard care. METHODS Forty adolescents with CD were randomized to a hypnosis intervention (HI) or waitlist control (WC) group. The intervention consisted of 1 in-person CH session, self-hypnosis education, and recordings for home practice. Data was collected at baseline, after the 8-week intervention, and at week 16. The primary outcome was patient- and parent-reported QoL; secondary outcomes were patient-reported abdominal pain, depression, anxiety, and sleep; school absences; and disease activity by Pediatric Crohn's Disease Activity Index. Paired and independent t-tests were used to compare differences from baseline to postintervention within and between groups. RESULTS Forty patients (50% girls, mean 15.8 years) were enrolled from February to May 2019. Seventy-eight percent had inactive disease, and 55% had abdominal pain. Post intervention, significant improvements were noted in HI parent-reported QoL compared with WC in total score (P = 0.05), social functioning (P = 0.01), and school functioning (P = 0.04) but patient-reported QoL was unchanged. Abdominal pain severity significantly improved in HI compared with WC (P = 0.03). School absences decreased in significantly more intervention than control patients (P = 0.01). Patients who practiced self-hypnosis consistently showed a trend toward greater QoL improvement than those who did not (P = 0.1). CONCLUSIONS CH is an acceptable and feasible adjunct in CD and may improve psychosocial QoL and abdominal pain. Further research is warranted.
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Affiliation(s)
- Amanda Lee
- Division of Pediatric Gastroenterology, Vanderbilt University Medical Center
| | - Dedrick Moulton
- Division of Pediatric Gastroenterology, Louisiana State University
| | - Lindsey Mckernan
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center
| | - Alexandra Russell
- Division of Pediatric Gastroenterology, Vanderbilt University Medical Center
| | - James C Slaughter
- Department of Biostatistics, Vanderbilt University School of Medicine
| | - Sari Acra
- Division of Pediatric Gastroenterology, Vanderbilt University Medical Center
| | - Lynn Walker
- Division of Adolescent and Young Adult Health, Vanderbilt University Medical Center, Portland, OR
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Lopes M, Dridi L, Yvernay R. Use of hypnosis preoperatively for surgery of the spine: Pilot study. Neurochirurgie 2020; 67:358-361. [PMID: 33340510 DOI: 10.1016/j.neuchi.2020.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 11/24/2020] [Accepted: 11/29/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Hypnosis is a technique requiring no drugs that acts during the three phases of surgery, reducing stress at the pre-surgical phase and the adminstration of anesthetic drugs during the intraoperative phase, as well as leading to improved management of postoperative pain and quality of life management. MATERIAL ET METHOD We carried out a retrospective study of 46 patients operated on for herniated disc or one or two-level laminectomy without arthrodesis. All patients benefited from a preoperative hypnosis session and completed a questionnaire about their possible concerns. The day after surgery, patients completed a second questionnaire on their postoperative experience following hypnosis. RESULTATS Our results indicate that this technique had a positive impact on the management of preoperative stress (80% of patients) and on postoperative quality of life (48% of patients). Pain measured by decreased from 4.8/10 preoperatively to 0.9/10 postoperatively. CONCLUSION Our results are consistent with previous findings in the literature as to the positive contribution of this technique in the management of preoperative stress and patient quality of life. Further studies are however required involving considerably larger cohorts and more extensive surgeries to confirm the effect of this technique on management of anesthesia and pain in spine surgery.
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Affiliation(s)
- M Lopes
- Neurosurgical Department, clinique d'Argonay (Ramsay-GDS), 685, route de Menthonnex, 74370 Argonay, France
| | - L Dridi
- Clinique d'Argonay (Ramsay-GDS), 685, route de Menthonnex, 74370 Argonay, France
| | - R Yvernay
- Anesthetic Department, clinique d'Argonay (Ramsay-GDS), 685, route de Menthonnex, 74370 Argonay, France
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Nowak H, Zech N, Asmussen S, Rahmel T, Tryba M, Oprea G, Grause L, Schork K, Moeller M, Loeser J, Gyarmati K, Mittler C, Saller T, Zagler A, Lutz K, Adamzik M, Hansen E. Effect of therapeutic suggestions during general anaesthesia on postoperative pain and opioid use: multicentre randomised controlled trial. BMJ 2020; 371:m4284. [PMID: 33303476 PMCID: PMC7726311 DOI: 10.1136/bmj.m4284] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To investigate the effect of therapeutic suggestions played to patients through earphones during surgery on postoperative pain and opioid use. DESIGN Blinded randomised controlled study. SETTING Five tertiary care hospitals in Germany. PARTICIPANTS 385 of 400 patients consecutively recruited from January to December 2018 who were to undergo surgery for 1-3 hours under general anaesthesia. In the per protocol analysis 191 patients were included in the intervention group and 194 patients in the control group. INTERVENTION The intervention comprised an audiotape of background music and positive suggestions based on hypnotherapeutic principles, which was played repeatedly for 20 minutes followed by 10 minutes of silence to patients through earphones during general anaesthesia. Patients in the control group were assigned to a blank tape. MAIN OUTCOME MEASURES The main outcome was dose of opioid administered by patient controlled analgesia or nurse controlled analgesia within the first postoperative 24 hours, based on regular evaluation of pain intensity on a numerical rating scale (range 0-10, with higher scores representing more severe pain). RESULTS Compared with the control group, the intervention group required a significantly (P=0.002) lower opioid dose within 24 hours after surgery, with a median of 4.0 mg (interquartile range 0-8) morphine equivalents versus 5.3 (2-12), and an effect size (Cohen's d) of 0.36 (95% confidence interval 0.16 to 0.56). The number of patients who needed opioids postoperatively was significantly (P=0.001) reduced in the intervention group: 121 of 191 (63%, 95% confidence interval 45% to 70%) patients in the intervention group versus 155 of 194 (80%, 74% to 85%) in the control group. The number needed to treat to avoid postoperative opioids was 6. Pain scores were consistently and significantly lower in the intervention group within 24 hours after surgery, with an average reduction of 25%. No adverse events were reported. CONCLUSIONS Therapeutic suggestions played through earphones during general anaesthesia could provide a safe, feasible, inexpensive, and non-drug technique to reduce postoperative pain and opioid use, with the potential for more general use. Based on the finding of intraoperative perception by a considerable number of patients, surgeons and anaesthetists should be careful about background noise and conversations during surgery. TRIAL REGISTRATION German Clinical Trial Register DRKS00013800.
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Affiliation(s)
- Hartmuth Nowak
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
- Contributed equally
| | - Nina Zech
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
- Contributed equally
| | - Sven Asmussen
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Tim Rahmel
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Michael Tryba
- Clinic for Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Kassel Hospital, Kassel, Germany
- Kassel School of Medicine, Kassel, Germany
| | - Guenther Oprea
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Lisa Grause
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Karin Schork
- Medizinisches Proteom-Center, Ruhr University Bochum, Bochum, Germany
| | | | - Johannes Loeser
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Katharina Gyarmati
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Corinna Mittler
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Thomas Saller
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Alexandra Zagler
- Department of Anaesthesiology, University Hospital, LMU Munich, Munich, Germany
| | - Katrin Lutz
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
| | - Michael Adamzik
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Ernil Hansen
- Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93042 Regensburg, Germany
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Vitale SG, Alonso Pacheco L, Haimovich S, Riemma G, De Angelis MC, Carugno J, Lasmar RB, Di Spiezio Sardo A. Pain management for in-office hysteroscopy. A practical decalogue for the operator. J Gynecol Obstet Hum Reprod 2020; 50:101976. [PMID: 33166706 DOI: 10.1016/j.jogoh.2020.101976] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/29/2020] [Accepted: 11/03/2020] [Indexed: 12/01/2022]
Abstract
Hysteroscopy is known to be the gold standard for evaluation of intrauterine pathologies, pre-menopausal and post-menopausal abnormal uterine bleeding and, in addition to this, it is a crucial examination in the infertility work-up. In-office operative hysteroscopy incorporates the outstanding possibility of seeing and treating an intracavitary pathology in the same examination, eliminating all the risk related to anesthesia and reducing procedure-related costs. By now, performing operative procedures in the office setting is recognized as feasible and safe. Over the last 20 years, many efforts have been made to implement the in-office operative approach worldwide. However, for some women, in-office hysteroscopy is still considered a painful experience, with reported discomfort at different steps of the hysteroscopic procedures. Moreover, uneventful and tedious sensations might be increased by a high level of anxiety for such examination. For this reason, despite the feasibility of the in-office approach, many clinicians are still afraid of provoking pain during the procedure and rather not to perform surgical procedures in the office, postponing the removal of the pathology in the operating room. To date, there is no consensus concerning pain management for in-office hysteroscopy and different approaches, pharmacological and non-pharmacological aids, as well as several procedural tips and tricks are utilized. Our purpose is to provide a feasible practical decalogue for the operator, to supply adequate management of pain during in-office hysteroscopic procedures, performing challenging operations, shrinking discomfort, aiming to upgrade both women's and operator's satisfaction.
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Affiliation(s)
- Salvatore Giovanni Vitale
- Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy.
| | | | - Sergio Haimovich
- Hillel Yaffe Medical Center, Technion-Israel Technology Institute, Hadera, Israel
| | - Gaetano Riemma
- Department of Woman, Child, and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Jose Carugno
- Obstetrics, Gynecology and Reproductive Sciences Department, Minimally Invasive Gynecology Unit, University of Miami, Miller School of Medicine, Miami, Florida, USA
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Riemma G, Schiattarella A, Colacurci N, Vitale SG, Cianci S, Cianci A, De Franciscis P. Pharmacological and non-pharmacological pain relief for office hysteroscopy: an up-to-date review. Climacteric 2020; 23:376-383. [PMID: 32396751 DOI: 10.1080/13697137.2020.1754388] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
In-office hysteroscopy is considered the standard technique for visualization of the uterine cavity and the diagnosis of intrauterine pathologies. Moreover, nowadays, it is possible to treat a vast number of intracavitary diseases in the office, without the need for the inpatient setting. However, in some cases, pain might occur, and this is the most common reason for not completing the procedure. Over the last 20 years, many efforts have been carried out to miniaturize the instrumentation and to improve the techniques in order to avoid discomfort. Nonetheless, hysteroscopy still provokes distress for many patients. For this reason, pharmacological and non-pharmacological treatments for intraoperative and postoperative pain relief have been widely used for in-office hysteroscopy, with different results in various groups of women. The purpose of this review was to analyze the current literature on pharmacological aids (non-steroidal anti inflammatory drugs, cyclooxygenase-2 inhibitors, antispasmodics, local anesthetics, prostaglandins, opioids) and non-pharmacological interventions (transcutaneous electrical nerve stimulation, uterine stretching, uterine pressure, warming of distension medium, hypnosis, music, vocal-local) and to evaluate their impact on the relief from pain experienced during in-office hysteroscopy.
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Affiliation(s)
- G Riemma
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Schiattarella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - N Colacurci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - S G Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - S Cianci
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - A Cianci
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - P De Franciscis
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
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Catsaros S, Wendland J. Hypnosis-based interventions during pregnancy and childbirth and their impact on women's childbirth experience: A systematic review. Midwifery 2020; 84:102666. [DOI: 10.1016/j.midw.2020.102666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/04/2020] [Accepted: 02/11/2020] [Indexed: 01/04/2023]
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Integrative Medicine in Interventional Oncology: A Virtuous Alliance. ACTA ACUST UNITED AC 2020; 56:medicina56010035. [PMID: 31963617 PMCID: PMC7022725 DOI: 10.3390/medicina56010035] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 01/11/2020] [Accepted: 01/13/2020] [Indexed: 12/16/2022]
Abstract
This review aimed to identify the potential role of integrative medicine in interventional oncology. The music therapy; stress management techniques; guided imagery, including virtual reality; clinical hypnosis; and digital sedation may all be efficient on anxiety and pain during procedures performed in interventional oncology. Beyond pharmacological sedation, the implementation of integrative medicine to interventional oncology may, therefore, improve the support and care of cancer patients, which may further create a virtuous alliance.
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29
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Radical Acceptance and Obesity-Related Health Conditions: A Case Report. J Clin Psychol Med Settings 2020; 27:217-225. [DOI: 10.1007/s10880-019-09696-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Scacchia P, De Pascalis V. Effects of Prehypnotic Instructions on Hypnotizability and Relationships Between Hypnotizability, Absorption, and Empathy. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2020; 62:231-266. [PMID: 31928517 DOI: 10.1080/00029157.2019.1586639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Although hypnotizability exhibits high across-time and across-test consistencies, it is not clear (a) how different preambles to a hypnotic procedure (metasuggestions) influence responsiveness to suggestions and the strength of the association between two hypnotizability scales and (b) how hypnotizability relates to absorption and empathy. In Experiment 1, nonclinical participants (N = 152 women) were administered the Modified Tellegen Absorption Scale (MODTAS), Interpersonal Reactivity Index (IRI), Hypnotic Induction Profile (HIP), and Stanford Hypnotic Susceptibility Scale, Form C (SHSS:C). In Experiment 2, nonclinical participants (N = 188; 105 women and 83 men) were administered the MODTAS, IRI, and Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS:A). The induction scores of the HIP (HIP-IND) and the SHSS:C scores showed a significantly stronger correlation when the HIP was introduced to the participants after hypnosis metasuggestion (HIP-H-IND) than after imagination metasuggestion (HIP-I-IND). Metasuggestion was a moderator of the association between HIP-IND and SHSS:C scores. Participants with low and medium, but not with high, hypnotizability levels on the SHSS:C showed significantly higher scores on the HIP-I-IND than on the HIP-H-IND. The strong correlations between the SHSS:C, HIP-H-IND, and HIP eye-roll (HIP-ER) scores indicate that both the HIP-H-IND and HIP-ER are robust measures of hypnotizability. Absorption and empathy were not significantly associated with hypnotizability. Women were more hypnotizable than men, as assessed by the HGSHS:A. The clinical relevance of metasuggestions, intended to increase responsiveness to suggestions, is discussed as a strategy to improve treatment outcomes.
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31
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Cornelis FH, Monard E, Moulin MA, Vignaud E, Laveissiere F, Ben Ammar M, Nouri-Neuville M, Barral M, Lombart B. Sedation and analgesia in interventional radiology: Where do we stand, where are we heading and why does it matter? Diagn Interv Imaging 2019; 100:753-762. [PMID: 31706790 DOI: 10.1016/j.diii.2019.10.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/13/2019] [Accepted: 10/20/2019] [Indexed: 11/28/2022]
Abstract
The aims of this review were to describe the rationale and the techniques of sedation in interventional radiology, and to compile the safety and efficacy results available so far in the literature. A systematic MEDLINE/PubMed literature search was performed. Preliminary results from several studies demonstrated the feasibility, the efficacy and the safety of using sedative techniques in interventional radiology. Beyond pharmacological sedation and clinical hypnosis, digital sedation could reduce the anxiety and pain associated with interventional radiology procedures.
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Affiliation(s)
- F H Cornelis
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France.
| | - E Monard
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M-A Moulin
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - E Vignaud
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - F Laveissiere
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M Ben Ammar
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M Nouri-Neuville
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - M Barral
- Department of Radiology, Tenon Hospital, Sorbonne University, AP-HP, 75020 Paris, France
| | - B Lombart
- Saint Antoine Hospital, Sorbonne université, AP-HP, 75011 Paris, France
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Noergaard MW, Håkonsen SJ, Bjerrum M, Pedersen PU. The effectiveness of hypnotic analgesia in the management of procedural pain in minimally invasive procedures: A systematic review and meta-analysis. J Clin Nurs 2019; 28:4207-4224. [PMID: 31410922 DOI: 10.1111/jocn.15025] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 07/18/2019] [Accepted: 08/04/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Patients undergoing minimally invasive procedures under a light conscious sedation perceive pain and anxiety. Hypnosis used together with analgesics has been investigated in numerous studies. AIMS AND METHODS To assess the effectiveness of hypnotic analgesia in management of pain, anxiety, analgesic consumption, procedure length and adverse events in adults undergoing minimally invasive procedures. Clinical controlled trials in which hypnosis was used together with pharmacological analgesia compared to pharmacological analgesia alone during invasive procedures were included. Seven databases were searched. The methodological quality of the studies was assessed by two reviewers using a standardised instrument for critical appraisal from Joanna Briggs Institute, 'Meta-Analysis of statistics assessment and review Instrument'. Meta-analyses using the review manager version 5.3 software were conducted on procedure length and adverse events. Results for pain, anxiety and analgesics were synthesised in narrative summaries. Conduction of the review adheres to the PRISMA checklist. RESULTS Ten studies comprising 1,365 participants were included. A reduction in the consumption of pain medication was found between 21%-86% without aggravating pain intensity and anxiety. In few studies, significant reduction in pain intensity and anxiety was found. Meta-analysis including seven studies revealed a small beneficial effect on reducing procedure length. A meta-analysis on adverse events showed no significant reduction. Statistical heterogeneity was found among the studies included. CONCLUSION For patients undergoing invasive procedures, hypnotic analgesia was effective in reducing consumption of analgesics. Only a slight effect was, however, found on experienced anxiety and pain intensity. It did not prolong the procedure and was safe to provide. RELEVANCE TO CLINICAL PRACTICE Hypnosis is recommended as pain management for adults during invasive procedures. A reduced consumption of pain medication potentially has a major impact on monitoring and observation of patients following the procedure, thus improving patient safety and reducing resource consumption.
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Affiliation(s)
- Marianne Wetendorff Noergaard
- Cardiology Clinic, The Heart Centre, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.,Danish Centre of Systematic Review - A JBI Center of Excellence, Aalborg University, Aalborg, Denmark
| | - Sasja Jul Håkonsen
- Danish Centre of Systematic Review - A JBI Center of Excellence, Aalborg University, Aalborg, Denmark.,Centre of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Merete Bjerrum
- Department of Nursing, Institute of Public Health, Aarhus University, Aarhus, Denmark
| | - Preben U Pedersen
- Danish Centre of Systematic Review - A JBI Center of Excellence, Aalborg University, Aalborg, Denmark.,Centre of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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Edwards DA, Hedrick TL, Jayaram J, Argoff C, Gulur P, Holubar SD, Gan TJ, Mythen MG, Miller TE, Shaw AD, Thacker JKM, McEvoy MD, Geiger TM, Gordon DB, Grant MC, Grocott M, Gupta R, Hah JM, Hurley RW, Kent ML, King AB, Oderda GM, Sun E, Wu CL. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Management of Patients on Preoperative Opioid Therapy. Anesth Analg 2019; 129:553-566. [DOI: 10.1213/ane.0000000000004018] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Prinsloo S, Rebello E, Cata JP, Black D, DeSnyder SM, Cohen L. Electroencephalographic correlates of hypnosedation during breast cancer surgery. Breast J 2019; 25:786-787. [PMID: 31127667 DOI: 10.1111/tbj.13328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/17/2018] [Accepted: 05/22/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Sarah Prinsloo
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Elizabeth Rebello
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Juan P Cata
- Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
- Anesthesiology and Surgical Oncology Research Group, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dalliah Black
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sarah M DeSnyder
- Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation, and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
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A Randomized Controlled Trial of Brief Mindfulness Meditation for Women Undergoing Stereotactic Breast Biopsy. J Am Coll Radiol 2019; 16:691-699. [DOI: 10.1016/j.jacr.2018.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 07/27/2018] [Accepted: 09/05/2018] [Indexed: 01/12/2023]
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Amer-Cuenca JJ, Marín-Buck A, Vitale SG, La Rosa VL, Caruso S, Cianci A, Lisón JF. Non-pharmacological pain control in outpatient hysteroscopies. MINIM INVASIV THER 2019; 29:10-19. [DOI: 10.1080/13645706.2019.1576054] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Juan J. Amer-Cuenca
- Department of Physiotherapy, Universidad Cardenal Herrera-CEU CEU Universities, Valencia, Spain
| | - Alejandro Marín-Buck
- Department of Surgery, Universidad Cardenal Herrera-CEU CEU Universities, Valencia, Spain
- Department of Gynecology, Hospital Provincial de Castellón, Castellón de la Plana, Spain
| | - Salvatore Giovanni Vitale
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | | | - Salvatore Caruso
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Antonio Cianci
- Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy
| | - Juan F. Lisón
- Department of Medicine, Universidad Cardenal Herrera-CEU CEU Universities, Valencia, Spain
- CIBER of Physiopathology of Obesity and Nutrition CIBERobn, CB06/03 Carlos III Health Institute, Madrid, Spain
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Chapet O, Udrescu C, Horn S, Ruffion A, Lorchel F, Gaudioz S, Clamens C, Piriou V, Rigal E. Prostate brachytherapy under hypnosedation: A prospective evaluation. Brachytherapy 2019; 18:22-28. [DOI: 10.1016/j.brachy.2018.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/28/2018] [Accepted: 10/17/2018] [Indexed: 10/27/2022]
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Stoerkel E, Bellanti D, Paat C, Peacock K, Aden J, Setlik R, Walter J, Inman A. Effectiveness of a Self-Care Toolkit for Surgical Breast Cancer Patients in a Military Treatment Facility. J Altern Complement Med 2018; 24:916-925. [PMID: 30247967 PMCID: PMC6157373 DOI: 10.1089/acm.2018.0069] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objective: To assess whether a self-care toolkit (SCT) provided to breast cancer patients undergoing surgery could mitigate distress and lessen symptoms associated with surgery. Design: One hundred women with breast cancer, planning to undergo initial surgery, were randomly assigned to either one of two groups: treatment as usual (TAU; n = 49) or TAU with the addition of an SCT (n = 51). The SCT contained an MP3 player with audio-files of guided mind–body techniques (breathing, progressive muscle relaxation, meditation, guided imagery, and self-hypnosis) and acupressure antinausea wristbands. Anxiety, pain, nausea, sleep, fatigue, global health, and quality of life (QOL) were assessed using validated outcome measures. Two inflammatory blood markers (erythrocyte sedimentation rate [ESR] and C-reactive protein [CRP]) were measured serially. Data were collected at baseline (T1), immediately before surgery (T2), within 10 h postoperatively (T3), and ∼2 weeks postsurgery (T4). Settings: Numerous studies have shown that psychological distress associated with a cancer diagnosis can affect pain perception and QOL. Results: Between T1 and T4, there were significant between-group differences in Patient-Reported Outcomes Measurement Information System (PROMIS)-57 scores of Pain Interference, Fatigue, and Satisfaction with Social Roles, favoring the SCT group compared with TAU (p = 0.005, p = 0.023, and p = 0.021, respectively). There was a significant mean change in Defense and Veterans Pain Rating Scale (DVPRS) scores from T2 to T3, with the SCT group having significantly smaller increases in postoperative pain (p = 0.008) and in postoperative ESR (p = 0.0197) compared with the TAU group. Clinically significant reductions in anxiety occurred in the SCT group during the main intervention period. Conclusion: These results suggest that using the SCT in the perioperative period decreased pain perceptions, fatigue, and inflammatory cytokine secretion.
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Affiliation(s)
- Erika Stoerkel
- 1 Thought Leadership and Innovation Foundation , McLean, VA
| | - Dawn Bellanti
- 1 Thought Leadership and Innovation Foundation , McLean, VA
| | - Charmagne Paat
- 1 Thought Leadership and Innovation Foundation , McLean, VA
| | - Kimberly Peacock
- 2 Department of Epidemiology & Biostatistics, University of Texas Health San Antonio , San Antonio, TX
| | - James Aden
- 3 Brooke Army Medical Center , Fort Sam Houston, TX
| | | | | | - Alice Inman
- 3 Brooke Army Medical Center , Fort Sam Houston, TX
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Investigation on the Neural Mechanism of Hypnosis-Based Respiratory Control Using Functional MRI. CONTRAST MEDIA & MOLECULAR IMAGING 2018; 2018:8182542. [PMID: 30065621 PMCID: PMC6051291 DOI: 10.1155/2018/8182542] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/26/2018] [Accepted: 05/16/2018] [Indexed: 11/22/2022]
Abstract
Respiratory control is essential for treatment effect of radiotherapy due to the high dose, especially for thoracic-abdomen tumor, such as lung and liver tumors. As a noninvasive and comfortable way of respiratory control, hypnosis has been proven effective as a psychological technology in clinical therapy. In this study, the neural control mechanism of hypnosis for respiration was investigated by using functional magnetic resonance imaging (fMRI). Altered spontaneous brain activity as well as neural correlation of respiratory motion was detected for eight healthy subjects in normal state (NS) and hypnosis state (HS) guided by a hypnotist. Reduced respiratory amplitude was observed in HS (mean ± SD: 14.23 ± 3.40 mm in NS, 12.79 ± 2.49 mm in HS, p=0.0350), with mean amplitude deduction of 9.2%. Interstate difference of neural activity showed activations in the visual cortex and cerebellum, while deactivations in the prefrontal cortex and precuneus/posterior cingulate cortex (PCu/PCC) in HS. Within these regions, negative correlations of neural activity and respiratory motion were observed in visual cortex in HS. Moreover, in HS, voxel-wise neural correlations of respiratory amplitude demonstrated positive correlations in cerebellum anterior lobe and insula, while negative correlations were shown in the prefrontal cortex and sensorimotor area. These findings reveal the involvement of cognitive, executive control, and sensorimotor processing in the control mechanisms of hypnosis for respiration, and shed new light on hypnosis performance in interaction of psychology, physiology, and cognitive neuroscience.
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Montgomery GH, Sucala M, Dillon MJ, Schnur JB. Interest and Attitudes about Hypnosis in a Large Community Sample. PSYCHOLOGY OF CONSCIOUSNESS (WASHINGTON, D.C.) 2018; 5:212-220. [PMID: 30035144 PMCID: PMC6052866 DOI: 10.1037/cns0000141] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite the available empirical evidence supporting the efficacy of hypnosis for alleviating symptoms and side effects across a variety of clinical contexts, hypnosis has failed to disseminate widely. One way to try to better understand the lack of hypnosis dissemination is to apply a marketing theory approach, focusing on attitudes and beliefs about a product (hypnosis) held by consumers. Better understanding of such factors can lead to strategies to promote the product among consumers, and in this case, encourage dissemination. The goal of the study was to investigate relationships between interest in hypnosis use and: 1) attitudes about hypnosis; 2) beliefs about the effectiveness of hypnosis (i.e., hypnosis credibility, and hypnosis effectiveness expectancies); 3) past experience with hypnosis; and 4) the perceived hedonic value and utility of hypnosis. The study also explored participants' preferences for hypnosis delivery method (i.e., live or recorded), as well as preferences for hypnosis labeling (i.e., how hypnosis is defined). Participants (N = 509) were recruited through Amazon Mechanical Turk and completed an anonymous online survey. The results revealed that participants' attitudes about hypnosis, their expectancies for the effectiveness of hypnosis, and the perceived hedonic value of hypnosis accounted for unique variance in participants' interest in hypnosis, ps < .05. Together, these variables accounted for 73% of the variance in participants' interest in hypnosis use. Based on these findings, we recommend that these key variables should be considered when planning for greater dissemination and uptake of empirically supported hypnosis interventions.
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Sterkers N, Chabrol JL, De Troyer J, Bonijol D, Darmon JC, Donnez O. Hypnosis as adjunct therapy to conscious sedation for venous access device implantation in breast cancer: A pilot study. J Vasc Access 2018; 19:382-386. [PMID: 29566587 DOI: 10.1177/1129729818757975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Recent reviews support that hypnosis has great potential for reducing pain and anxiety during mini-invasive surgery. Here, we assessed the feasibility of hypnotic induction session as adjunct therapy in conscious sedation for venous access device implantation. Primary outcomes were safety and patient satisfaction. METHODS Thirty consecutive women with breast cancer were proposed adjunct of hypnosis before implantation under conscious sedation (midazolam: 0.5 mg ± bolus of Ketamin: 5 mg on demand) indicated for chemotherapy. Self-hypnosis was programmed and guided by one of two trained anesthesiologists. Implantation was performed by one of two experimented surgeons. It consisted of blind subclavian implantation of Braun ST 305 devices using a percutaneous technique adapted from Selinger's procedure. Clinical data were prospectively collected and retrospectively analyzed. A comprehensive custom-made questionnaire recorded patient satisfaction. RESULTS In all, 30/30 patients consented to the procedure. The median age was 54 years (range: 35-77 years). The primary procedure was successful in 29/30. One case was converted into internal jugular vein access after a first attempt. Median length time of the implantation procedure in the operative room was 20 min (range: 10-60 min). Median length time in the recovery room preceding home discharge was 65 min (range: 15-185 min). None of the patients suffered complications. The satisfaction rate was ≥90%, 27/30 patients would get hypnosis in case of reimplantation if necessary and 27/30 would recommend this procedure to others. CONCLUSION Hypnosis under conscious sedation appears feasible and safe for port implantation under conscious sedation in cancer patients. Further studies would determine the exact value of hypnosis effectiveness.
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Affiliation(s)
| | - Jean L Chabrol
- 2 Anesthesia Department, Urbain V Clinic, Avignon, France
| | | | - Dany Bonijol
- 2 Anesthesia Department, Urbain V Clinic, Avignon, France
| | - Jean C Darmon
- 1 Gynecologic Department, Urbain V Clinic, Avignon, France
| | - Olivier Donnez
- 1 Gynecologic Department, Urbain V Clinic, Avignon, France
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Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S. Psychological interventions for acute pain after open heart surgery. Cochrane Database Syst Rev 2017; 7:CD009984. [PMID: 28701028 PMCID: PMC6432747 DOI: 10.1002/14651858.cd009984.pub3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation. SEARCH METHODS For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, and PsycINFO for eligible studies up to February 2017. We used the 'related articles' and 'cited by' options of eligible studies to identify additional relevant studies. We checked lists of references of relevant articles and previous reviews. We searched the ProQuest Dissertations and Theses Full Text Database, ClinicalTrials and the WHO International Clinical Trials Registry Platform to identify any unpublished material or ongoing trials. We also contacted the authors of primary studies to identify any unpublished material. In addition, we wrote to all leading heart centres in Germany, Switzerland, and Austria to check whether they were aware of any ongoing trials. SELECTION CRITERIA Randomised controlled trials comparing psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery. DATA COLLECTION AND ANALYSIS Two review authors (SZ and SK) independently assessed trials for eligibility, estimated the risk of bias and extracted all data. We calculated effect sizes for each comparison (Hedges' g) and meta-analysed data using a random-effects model. We assessed the evidence using GRADE and created 'Summary of findings' tables. MAIN RESULTS We added six studies to this update. Overall, we included 23 studies (2669 participants).For the majority of outcomes (two-thirds), we could not perform a meta-analysis since outcomes were not measured, or data were provided by one trial only.No study reported data on the number of participants with pain intensity reduction of at least 50% from baseline. Only one study reported data on the number of participants below 30/100 mm on the Visual Analogue Scale (VAS) in pain intensity (very low-quality evidence). Psychological interventions did not reduce pain intensity in the short-term interval (g 0.39, 95% CI -0.18 to 0.96, 2 studies, 104 participants, low-quality evidence), medium-term interval (g -0.02, 95% CI -0.24 to 0.20, 4 studies, 413 participants, moderate-quality evidence) or in the long-term interval (g 0.05, 95% CI -0.20 to 0.30, 2 studies, 200 participants, moderate-quality evidence).No study reported data on median time to re-medication or on number of participants re-medicated. Only two studies provided data on postoperative analgesic use in the short-term interval, showing that psychological interventions did not reduce the use of analgesic medication (g 1.18, 95% CI -2.03 to 4.39, 2 studies, 104 participants, low-quality evidence). Studies revealed that psychological interventions reduced mental distress in the medium-term (g 0.37, 95% CI 0.13 to 0.60, 13 studies, 1388 participants, moderate-quality evidence) and likewise in the long-term interval (g 0.32, 95% CI 0.10 to 0.53, 14 studies, 1586 participants, moderate-quality evidence). Psychological interventions did not improve mobility in the medium-term interval (g 0.23, 95% CI -0.22 to 0.67, 3 studies, 444 participants, low-quality evidence), nor in the long-term interval (g 0.09, 95% CI -0.10 to 0.28, 4 studies, 458 participants, moderate-quality evidence). Only two studies reported data on time to extubation, indicating that psychological interventions reduced the time to extubation (g 0.56, 95% CI 0.08 to 1.03, 2 studies, 154 participants, low-quality evidence).Overall, the very low to moderate quality of the body of evidence on the efficacy of psychological interventions for acute pain after open heart surgery cannot be regarded as sufficient to draw robust conclusions.Most 'Risk of bias' assessments were low or unclear. We judged selection bias (random sequence generation) and attrition bias to be mostly low risk for included studies. However, we judged the risk of selection bias (allocation concealment), performance bias, detection bias and reporting bias to be mostly unclear. AUTHORS' CONCLUSIONS In line with the conclusions of our previous review, there is a lack of evidence to support or refute psychological interventions in order to reduce postoperative pain in participants undergoing open heart surgery. We found moderate-quality evidence that psychological interventions reduced mental distress in participants undergoing open heart surgery. Given the small numbers of studies, it is not possible to draw robust conclusions on the efficacy of psychological interventions on outcomes such as analgesic use, mobility, and time to extubation respectively on adverse events or harms of psychological interventions.
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Affiliation(s)
- Susanne Ziehm
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Jenny Rosendahl
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Jürgen Barth
- UniversityHospital and University of ZurichInstitute for Complementary and Integrative MedicineSonneggstrasse 6ZurichSwitzerlandCH‐8091
| | - Bernhard M Strauss
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Anja Mehnert
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Susan Koranyi
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
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Chen PY, Liu YM, Chen ML. The Effect of Hypnosis on Anxiety in Patients With Cancer: A Meta-Analysis. Worldviews Evid Based Nurs 2017; 14:223-236. [DOI: 10.1111/wvn.12215] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Pei-Ying Chen
- Doctoral Candidate, Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan and Instructor, Department of Nursing; Yuanpei University of Medical Technology; Hsin-Chu Taiwan
| | - Ying-Mei Liu
- Associate Professor, Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
| | - Mei-Ling Chen
- Professor, School of Nursing, College of Medicine, Chang Gung University; Researcher, Division of Medical Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou Branch and Professor, Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
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Rosendahl J, Koranyi S, Jacob D, Zech N, Hansen E. Efficacy of therapeutic suggestions under general anesthesia: a systematic review and meta-analysis of randomized controlled trials. BMC Anesthesiol 2016; 16:125. [PMID: 28007033 PMCID: PMC5178078 DOI: 10.1186/s12871-016-0292-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/13/2016] [Indexed: 01/20/2023] Open
Abstract
Background General anesthesia does not block central nervous processing of auditive information. Therefore, positive suggestions even given during surgery might have the potential to encourage well-being and recovery of patients. Aim of this review was to summarize the evidence on the efficacy of therapeutic suggestions under general anesthesia in adults undergoing surgery compared to an attention control (i.e. white noise). Methods We included randomized controlled trials that investigated therapeutic suggestions presented during general anesthesia to adult patients undergoing surgery or medical procedures. Outcomes on pain intensity, mental distress, recovery, use of medication, measured postoperatively within hospitalization were considered. Electronic searches were carried out in the following databases (last search February 23, 2015): MEDLINE, CENTRAL, Web of Science, PsycINFO, ProQuest Dissertations and Theses. Results Thirty-two eligible randomized controlled trials were included, comprising a total of 2102 patients. All studies used taped suggestions. Random effects meta-analyses revealed no effects on pain intensity (Hedges’ g = 0.04, CI 95% [−0.04; 0.12], number needed to treat [NNT] = 44.3) and mental distress (g = 0.03, CI 95% [−0.11; 0.16], NNT = 68.2). In contrast, we found small but significant positive effects on use of medication (g = 0.19, CI 95% [0.09; 0.29], NNT = 9.2) and on recovery (g = 0.14, CI 95% [0.03; 0.25], NNT = 13.0). All effects were homogeneous and robust. Conclusions Even though effects were small, our results provide indications that intraoperative suggestions can have the potential to reduce the need for medication and enhance recovery. Further high quality trials are needed to strengthen the promising evidence on the efficacy of therapeutic suggestions under general anesthesia for patients undergoing surgery. Electronic supplementary material The online version of this article (doi:10.1186/s12871-016-0292-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany.
| | - Susan Koranyi
- Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Philipp-Rosenthal-Str. 55, 04103, Leipzig, Germany
| | - Davina Jacob
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Friedrich-Schiller University, Stoystr. 3, 07743, Jena, Germany
| | - Nina Zech
- Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
| | - Ernil Hansen
- Department of Anaesthesiology, University Hospital Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany
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Heilmann C, Stotz U, Burbaum C, Feuchtinger J, Leonhart R, Siepe M, Beyersdorf F, Fritzsche K. Short-term intervention to reduce anxiety before coronary artery bypass surgery--a randomised controlled trial. J Clin Nurs 2016; 25:351-61. [PMID: 26818362 DOI: 10.1111/jocn.13055] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2015] [Indexed: 12/19/2022]
Abstract
AIMS AND OBJECTIVES The aim of this study was to evaluate an intervention with individualised information and emotional support before coronary artery bypass grafting in a controlled randomised trial. BACKGROUND Anxiety is a typical phenomenon in patients who are to undergo cardiac surgery. Preoperative anxiety has been shown to correlate to adverse postoperative outcomes. Emotional support could be an effective measure to reduce preoperative anxiety. DESIGN AND METHODS Patients with planned first coronary artery bypass grafting were randomised into an intervention group (n = 139) and a control group (n = 114). The patients of the control group were routinely informed as usual. The patients of the intervention group received a dialogue with individualised information and emotional support one day before surgery in addition to standard care. This intervention of ~30 minutes was based on a supportive psychotherapy model and was delivered by trained nurses. The primary outcome was the change in anxiety before operation. The secondary outcomes consisted of changes in postoperative anxiety, time on intensive care unit and in-hospital mortality. RESULTS Significantly reduced anxiety was found in the intervention group patients compared to control patients before coronary artery bypass grafting (p < 0·001) and five days after surgery (p < 0·001). Both groups did not differ in in-hospital mortality and duration of stay in the intensive care unit. CONCLUSIONS Our short-term psychosocial intervention in patients undergoing coronary artery bypass grafting had a beneficial effect on reducing pre- and postoperative anxiety that was better than routine information alone. RELEVANCE TO CLINICAL PRACTICE These results advocate training for nurses and physicians to provide emotional support to patients before coronary artery bypass grafting.
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Affiliation(s)
- Claudia Heilmann
- Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany
| | - Ulrike Stotz
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
| | | | - Johanna Feuchtinger
- Quality and Development in Nursing Care, Medical Center, University of Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Matthias Siepe
- Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany
| | - Friedhelm Beyersdorf
- Department of Cardiovascular Surgery, Heart Center, University of Freiburg, Freiburg, Germany
| | - Kurt Fritzsche
- Department of Psychosomatic Medicine and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
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Hypnosis in the Perioperative Management of Breast Cancer Surgery: Clinical Benefits and Potential Implications. Anesthesiol Res Pract 2016; 2016:2942416. [PMID: 27635132 PMCID: PMC5011203 DOI: 10.1155/2016/2942416] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 01/15/2023] Open
Abstract
The aim of this review is to summarize data published on the use of perioperative hypnosis in patients undergoing breast cancer surgery (BCS). Indeed, the majority of BCS patients experience stress, anxiety, nausea, vomiting, and pain. Correct management of the perioperative period and surgical removal of the primary tumor are clearly essential but can affect patients on different levels and hence have a negative impact on oncological outcomes. This review examines the effect of clinical hypnosis performed during the perioperative period. Thanks to its specific properties and techniques allowing it to be used as complementary treatment preoperatively, hypnosis has an impact most notably on distress and postoperative pain. During surgery, hypnosis may be applied to limit immunosuppression, while, in the postoperative period, it can reduce pain, anxiety, and fatigue and improve wound healing. Moreover, hypnosis is inexpensive, an important consideration given current financial concerns in healthcare. Of course, large randomized prospective studies are now needed to confirm the observed advantages of hypnosis in the field of oncology.
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Häuser W, Hagl M, Schmierer A, Hansen E. The Efficacy, Safety and Applications of Medical Hypnosis. DEUTSCHES ARZTEBLATT INTERNATIONAL 2016; 113:289-96. [PMID: 27173407 PMCID: PMC4873672 DOI: 10.3238/arztebl.2016.0289] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 01/07/2016] [Accepted: 01/07/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The efficacy and safety of hypnotic techniques in somatic medicine, known as medical hypnosis, have not been supported to date by adequate scientific evidence. METHODS We systematically reviewed meta-analyses of randomized controlled trials (RCTs) of medical hypnosis. Relevant publications (January 2005 to June 2015) were sought in the Cochrane databases CDSR and DARE, and in PubMed. Meta-analyses involving at least 400 patients were included in the present analysis. Their methodological quality was assessed with AMSTAR (A Measurement Tool to Assess Systematic Reviews). An additional search was carried out in the CENTRAL and PubMed databases for RCTs of waking suggestion (therapeutic suggestion without formal trance induction) in somatic medicine. RESULTS Out of the 391 publications retrieved, five were reports of metaanalyses that met our inclusion criteria. One of these meta-analyses was of high methodological quality; three were of moderate quality, and one was of poor quality. Hypnosis was superior to controls with respect to the reduction of pain and emotional stress during medical interventions (34 RCTs, 2597 patients) as well as the reduction of irritable bowel symptoms (8 RCTs, 464 patients). Two meta-analyses revealed no differences between hypnosis and control treatment with respect to the side effects and safety of treatment. The effect size of hypnosis on emotional stress during medical interventions was low in one meta-analysis, moderate in one, and high in one. The effect size on pain during medical interventions was low. Five RCTs indicated that waking suggestion is effective in medical procedures. CONCLUSION Medical hypnosis is a safe and effective complementary technique for use in medical procedures and in the treatment of irritable bowel syndrome. Waking suggestions can be a component of effective doctor-patient communication in routine clinical situations.
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Affiliation(s)
- Winfried Häuser
- Department of Internal Medicine I, Klinikum Saarbrücken, Saarbrücken and Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich
| | - Maria Hagl
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich
| | | | - Ernil Hansen
- Department of Anesthesiology, Universitätsklinikum Regensburg
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Stone AB, Sheinberg R, Bertram A, Seymour AR. Are Anesthesia Providers Ready for Hypnosis? Anesthesia Providers' Attitudes Toward Hypnotherapy. AMERICAN JOURNAL OF CLINICAL HYPNOSIS 2016; 58:411-8. [PMID: 27003489 DOI: 10.1080/00029157.2015.1136589] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study sought to measure current attitudes toward hypnosis among anesthesia providers using an in-person survey distributed at a single grand rounds at a single academic teaching hospital. One hundred twenty-six anesthesia providers (anesthesiologists and nurse anesthetists) were included in this study. A 10-question Institutional Review Board (IRB)-approved questionnaire was developed. One hundred twenty-six (73% of providers at the meeting) anesthesia providers completed the survey. Of the respondents, 54 (43%) were anesthesiologists, 42 (33%) were trainees (interns/residents/fellows) in anesthesia, and 30 (24%) were nurse anesthetists. Over 70% of providers, at each level of training, rated their knowledge of hypnosis as either below average or having no knowledge. Fifty-two (42%) providers agreed or strongly agreed that hypnotherapy has a place in the clinical practice of anesthesia, while 103 (83%) believed that positive suggestion has a place in the clinical practice of anesthesia (p < .0001). Common reasons cited against using hypnosis were that it is too time consuming (41%) and requires special training (34%). Only three respondents (2%) believed that there were no reasons for using hypnosis in their practice. These data suggest that there is a self-reported lack of knowledge about hypnosis among anesthesia providers, although many anesthesia providers are open to the use of hypnosis in their clinical practice. Anesthesia providers are more likely to support the use of positive suggestion in their practice than hypnosis. Practical concerns should be addressed if hypnosis and therapeutic verbal techniques are to gain more widespread use.
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Kendrick C, Sliwinski J, Yu Y, Johnson A, Fisher W, Kekecs Z, Elkins G. Hypnosis for Acute Procedural Pain: A Critical Review. Int J Clin Exp Hypn 2016; 64:75-115. [PMID: 26599994 PMCID: PMC5120961 DOI: 10.1080/00207144.2015.1099405] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Clinical evidence for the effectiveness of hypnosis in the treatment of acute procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions.
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Affiliation(s)
| | | | - Yimin Yu
- a Baylor University , Waco , Texas , USA
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Hypnotherapy for insomnia: A systematic review and meta-analysis of randomized controlled trials. Complement Ther Med 2015; 23:719-32. [DOI: 10.1016/j.ctim.2015.07.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 05/29/2015] [Accepted: 07/31/2015] [Indexed: 11/22/2022] Open
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