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Levit T, Grzela P, Lavoie DCT, Wang L, Agarwal A, Couban RJ, Shanthanna H. The Effectiveness of Virtual and Augmented Reality in Surgical Pain Management: A Systematic Review of Randomized Controlled Trials. Anesth Analg 2024:00000539-990000000-00888. [PMID: 39088374 DOI: 10.1213/ane.0000000000007051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
BACKGROUND Satisfactory management of postoperative pain remains challenging. Nonpharmacological modalities such as virtual and augmented reality (VR/AR) offer potential benefits and are becoming increasingly popular. This systematic review evaluates the effectiveness and safety of VR/AR interventions on postoperative pain and recovery. METHODS MEDLINE, Embase, CINAHL, Web of Science, and CENTRAL databases were searched from inception to July 27, 2023, for randomized controlled trials (RCTs), published in English, evaluating the use of VR/AR interventions for surgical pain relief. Study selection and data extraction were performed by pairs of reviewers independently and in duplicate, and potential risk of bias was determined using the Risk of Bias-version 2 (RoB 2) tool. Our outcomes included pain relief, reduction of anxiety, satisfaction, and adverse effects. Due to substantial heterogeneity, a narrative synthesis without meta-analysis was performed. RESULTS We included 35 trials among 2257 citations, categorized as surgery (n = 12), minor procedures (n = 15), and postoperative physiotherapy (n = 8). Surgical group included various surgeries, with 11 using immersive VR predominantly in the postoperative period, and most reporting no differences in pain, but potential for reduced anxiety and sedation requirements. In the minor procedures group, most studies reported decreased pain and anxiety during the procedural performance. Two studies reported increased heart rate, while 2 others reported better hemodynamic stability. Home-based AR physiotherapy achieved (n = 6) similar pain and functional outcomes after knee replacement, with 1 large study (n = 306) reporting reduction of mean costs by $2745 for provision of 12 weeks physiotherapy. There were some concerns around potential bias for most studies, as the nature of interventions make it challenging to blind assessors and participants. No important adverse effects were noted using VR/AR technology. CONCLUSIONS Evidence from RCTs indicates that the use of immersive VR during minor procedures may reduce procedural pain, decrease anxiety, and improve satisfaction. However, small studies, inconsistent effect, and variation in the application of interventions are important limitations. Evidence to support the application of AR/VR for major surgeries is limited and needs to be further investigated. Use of home-based physiotherapy with AR likely has economic advantages, and facilitates virtual care for appropriate patients who can access and use the technology safely.
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Affiliation(s)
- Tal Levit
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Patrick Grzela
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Declan C T Lavoie
- From the Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Li Wang
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Aashna Agarwal
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Rachel J Couban
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
| | - Harsha Shanthanna
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, Ontario, Canada
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Magi CE, Longobucco Y, Amato C, Camedda C, Balestri C, El Aoufy K, Iovino P, Bambi S, Rasero L. Enhancing the comfort of hospitalized elderly patients: pain management strategies for painful nursing procedures. Front Med (Lausanne) 2024; 11:1390695. [PMID: 38966534 PMCID: PMC11223755 DOI: 10.3389/fmed.2024.1390695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/05/2024] [Indexed: 07/06/2024] Open
Affiliation(s)
| | - Yari Longobucco
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Carla Amato
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Claudia Camedda
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Department of Head and Neck District Diseases, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Chiara Balestri
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Khadija El Aoufy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Paolo Iovino
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Stefano Bambi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Laura Rasero
- Department of Health Sciences, University of Florence, Florence, Italy
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Cossu G, Vandenbulcke A, Zaccarini S, Gaudet JG, Hottinger AF, Rimorini N, Potie A, Beaud V, Guerra-Lopez U, Daniel RT, Berna C, Messerer M. Hypnosis-Assisted Awake Craniotomy for Eloquent Brain Tumors: Advantages and Pitfalls. Cancers (Basel) 2024; 16:1784. [PMID: 38730736 PMCID: PMC11083963 DOI: 10.3390/cancers16091784] [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: 04/11/2024] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Awake craniotomy (AC) is recommended for the resection of tumors in eloquent areas. It is traditionally performed under monitored anesthesia care (MAC), which relies on hypnotics and opioids. Hypnosis-assisted AC (HAAC) is an emerging technique that aims to provide psychological support while reducing the need for pharmacological sedation and analgesia. We aimed to compare the characteristics and outcomes of patients who underwent AC under HAAC or MAC. METHODS We retrospectively analyzed the clinical, anesthetic, surgical, and neuropsychological data of patients who underwent awake surgical resection of eloquent brain tumors under HAAC or MAC. We used Mann-Whitney U tests, Wilcoxon signed-rank tests, and repeated-measures analyses of variance to identify statistically significant differences at the 0.05 level. RESULTS A total of 22 patients were analyzed, 14 in the HAAC group and 8 in the MAC group. Demographic, radiological, and surgical characteristics as well as postoperative outcomes were similar. Patients in the HAAC group received less remifentanil (p = 0.047) and propofol (p = 0.002), but more dexmedetomidine (p = 0.025). None of them received ketamine as a rescue analgesic. Although patients in the HAAC group experienced higher levels of perioperative pain (p < 0.05), they reported decreasing stress levels (p = 0.04) and greater levels of satisfaction (p = 0.02). CONCLUSION HAAC is a safe alternative to MAC as it reduces perioperative stress and increases overall satisfaction. Further research is necessary to assess whether hypnosis is clinically beneficial.
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Affiliation(s)
- Giulia Cossu
- Department of Neurosurgery, University Hospital of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland; (A.V.); (R.T.D.); (M.M.)
- L. Lundin and Family Brain Tumor Research Center, Departments of Oncology and Clinical Neurosciences, University Hospital of Lausanne, 1011 Lausanne, Switzerland;
| | - Alberto Vandenbulcke
- Department of Neurosurgery, University Hospital of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland; (A.V.); (R.T.D.); (M.M.)
| | - Sonia Zaccarini
- Department of Anesthesiology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (S.Z.); (J.G.G.)
- Center for Integrative and Complementary Medicine, Department of Anesthesiology, University Hospital of Lausanne, The Sense and University of Lausanne, 1011 Lausanne, Switzerland; (N.R.); (C.B.)
| | - John G. Gaudet
- Department of Anesthesiology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (S.Z.); (J.G.G.)
| | - Andreas F. Hottinger
- L. Lundin and Family Brain Tumor Research Center, Departments of Oncology and Clinical Neurosciences, University Hospital of Lausanne, 1011 Lausanne, Switzerland;
- Division of Neuro-oncology, Department of Oncology, University Hospital of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland
| | - Nina Rimorini
- Center for Integrative and Complementary Medicine, Department of Anesthesiology, University Hospital of Lausanne, The Sense and University of Lausanne, 1011 Lausanne, Switzerland; (N.R.); (C.B.)
| | - Arnaud Potie
- Department of Anesthesiology, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (S.Z.); (J.G.G.)
| | - Valerie Beaud
- Service of Neuropsychology and Neurorehabilitation, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (V.B.); (U.G.-L.)
| | - Ursula Guerra-Lopez
- Service of Neuropsychology and Neurorehabilitation, University Hospital of Lausanne, 1011 Lausanne, Switzerland; (V.B.); (U.G.-L.)
| | - Roy T. Daniel
- Department of Neurosurgery, University Hospital of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland; (A.V.); (R.T.D.); (M.M.)
- L. Lundin and Family Brain Tumor Research Center, Departments of Oncology and Clinical Neurosciences, University Hospital of Lausanne, 1011 Lausanne, Switzerland;
| | - Chantal Berna
- Center for Integrative and Complementary Medicine, Department of Anesthesiology, University Hospital of Lausanne, The Sense and University of Lausanne, 1011 Lausanne, Switzerland; (N.R.); (C.B.)
| | - Mahmoud Messerer
- Department of Neurosurgery, University Hospital of Lausanne and University of Lausanne, 1011 Lausanne, Switzerland; (A.V.); (R.T.D.); (M.M.)
- L. Lundin and Family Brain Tumor Research Center, Departments of Oncology and Clinical Neurosciences, University Hospital of Lausanne, 1011 Lausanne, Switzerland;
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Schmidt B, Böhmer J, Schnuerch M, Koch T, Michelmann S. Post-hypnotic suggestion improves confidence and speed of memory access with long-lasting effects. Acta Psychol (Amst) 2024; 245:104240. [PMID: 38569321 DOI: 10.1016/j.actpsy.2024.104240] [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: 10/31/2023] [Revised: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/05/2024] Open
Abstract
In our study, we use the post-hypnotic suggestion of easy remembering to improve memory with long-lasting effects. We tested 24 highly suggestible participants in an online study. Participants learned word lists and recalled them later in a recognition memory task. At the beginning of the study, participants were hypnotized and the post-hypnotic suggestion to remember easily was associated with a cue that participants used during the recognition memory task. In a control condition, the same participants used a neutral cue. One week later, participants repeated both conditions with new word lists. Participants were significantly faster and more confident in their recognition ratings in the easy-remembering condition compared to the control condition, and this effect persisted over one week. Crucially, the increased speed and confidence in the easy-remembering condition did not affect memory accuracy. That makes our hypnosis intervention promising for patients experiencing subjective memory impairments. APA PSYCINFO CODES: 2343 (Learning and Memory), 2380 (Consciousness States), 3351 (Clinical Hypnosis).
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Affiliation(s)
- Barbara Schmidt
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany; Institute of Psychology, University of Jena, Jena, Germany.
| | - Justin Böhmer
- Institute of Psychology, University of Jena, Jena, Germany; Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | | | - Tobias Koch
- Institute of Psychology, University of Jena, Jena, Germany
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van Tilburg MAL, Monis EL, Braumann RE, Fleishman K, Lamm K. Hypnotherapy as a medical treatment: Evidence-based or pseudoscience? Complement Ther Clin Pract 2024; 55:101841. [PMID: 38387324 DOI: 10.1016/j.ctcp.2024.101841] [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: 09/15/2023] [Revised: 02/06/2024] [Accepted: 02/09/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Hypnotherapy continues to be a controversial practice in medicine. It is surrounded by myth and misuses that instill doubts about its legitimacy and usefulness. PURPOSE In this paper, we will distinguish pseudoscientific claims from evidence-based uses of hypnotherapy. RESULTS The use and acceptability of hypnotherapy has varied over history. Pseudoscientific uses, based on outdated theories that it can access the unconscious mind, have delegitimized hypnotherapy. Modern theories that hypnosis uses common social, emotional, and cognitive processes combined with evidence-based methods have re-established the use of hypnotherapy in many physical and mental health disorders and symptoms. Currently it is a widely accepted and recommended treatment for irritable bowel syndrome, with evidence building for many other applications. CONCLUSION Hypnotherapy, as a pseudoscience, can become unethical and cause distress for the patient and their families. Hypnotherapy, as an evidence-based treatment, can be used as a powerful tool to treat physical and psychological symptoms related to medical ailments.
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Affiliation(s)
- Miranda A L van Tilburg
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA; Marshall University, Huntington, WV, USA; University of North Carolina, Chapel Hill, NC, USA; University of Washington, Seattle, WA, USA.
| | - Elizabeth L Monis
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Ryan E Braumann
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Kenneth Fleishman
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
| | - Kevin Lamm
- Cape Fear Valley Health, Fayetteville NC, USA; Campbell University, Lillington, NC, USA
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Peter B. Hypnosis in psychotherapy, psychosomatics and medicine. A brief overview. Front Psychol 2024; 15:1377900. [PMID: 38659672 PMCID: PMC11040694 DOI: 10.3389/fpsyg.2024.1377900] [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: 01/28/2024] [Accepted: 02/29/2024] [Indexed: 04/26/2024] Open
Abstract
Aspects of hypnosis and its application in psychotherapy, psychosomatics and medicine are examined and contextualized in the 250-year history of hypnosis. Imagination as an essential element of hypnotic treatments appeared as early as 1784 as an argument rejecting the theory of animal magnetism of Franz Anton Mesmer. In somnambulism of German romanticism, another proto-form of hypnosis after 1800, concepts of the mind-body problem were dealt with, which still characterize the understanding of unconscious mental processes today. Hypnosis was at the beginning of psychoanalysis, but was not pursued further by Sigmund Freud from 1900 onwards. Nevertheless, there were some hypnoanalytical approaches in the 20th century, as well as attempts to integrate hypnosis into behavior therapy. Techniques of imagination and relaxation combine both; in particular findings from cognitive psychology explain processes of both hypnosis and cognitive behavioral therapy. The influence of social psychology brought a new perspective to the debate about the nature of hypnosis, which continues to this day: is hypnosis to be understood as a special state of consciousness or is it a completely normal, mundane interaction? The experiments that were carried out to support one side or the other were also dependent on the hypnotizability of the subjects involved, as the more difficult hypnotic phenomena such as paralysis, hallucinations or identity delusions can only be demonstrated by highly hypnotizable subjects. The fact that these are not mere compliance reactions has now been proven by many studies using imaging techniques. But even those who are moderately hypnotizable benefit from hypnosis rituals. Variables postulated by socio-cognitive hypnosis researchers, such as motivation and expectation, are relevant, as is a good "hypnotic rapport." Practical application of hypnotherapy today is characterized by the innovative techniques and strategies developed by Milton H. Erickson. Research into the effectiveness of hypnosis in the field of psychotherapy and psychosomatics still leaves much to be done. The situation is different in the field of medical hypnosis, where there are considerably more studies with a satisfactory design and verifiable effects. However, the impact in practical application in everyday medical practice is still low. Newer developments such as virtual reality and artificial intelligence are being looked at with critical interest.
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Affiliation(s)
- Burkhard Peter
- MEG-Foundation, Wilhelmsthal-Hesselbach, Germany
- School of Dental Medicine, University of Bern, Bern, Switzerland
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Schmidt B, Rohleder N, Engert V. Post-hypnotic safety suggestion improves stress coping with long-lasting effects. Sci Rep 2024; 14:3548. [PMID: 38347065 PMCID: PMC10861489 DOI: 10.1038/s41598-024-54071-3] [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: 06/21/2023] [Accepted: 02/08/2024] [Indexed: 02/15/2024] Open
Abstract
Effective coping with acute stress is important to promote mental health and to build stress resilience. Interventions improving stress coping usually require long training periods. In this study, we present a hypnosis-based intervention that produces long-term effects after a single hypnosis session. In that session, we established a post-hypnotic safety suggestion that participants can activate afterwards with a cue, the Jena Safety Anchor. We tested 60 participants in our study who all received the hypnosis session and a stress task. The safety group used the Jena Safety Anchor during acute stress (Trier Social Stress Test, TSST). The control group used a neutral anchor. We measured subjective stress responses via self-reports and physiological stress responses via saliva and blood samples as well as heart rate. One week later, all participants filled in an online survey to measure long-term effects of the post-hypnotic safety suggestion. We found that participants using the Jena Safety Anchor during the TSST reported significantly lower stress compared to the control group. The safety group also reported significantly fewer negative thoughts concerning their TSST performance than the control group during the stress recovery phase and 1 week later. All participants indicated that the Jena Safety Anchor still worked 1 week after its establishment. Suggestibility did not affect the efficacy of the Jena Safety Anchor. Our findings demonstrate that post-hypnotic safety suggestions improve stress coping with long-lasting effects, which makes it a promising intervention to promote mental health and establish stress resilience in just one hypnosis session.
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Affiliation(s)
- Barbara Schmidt
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Stoystraße 3, 07743, Jena, Germany.
| | - Nicolas Rohleder
- Chair of Health Psychology, Institute of Psychology, Friedrich-Alexander-Universität, Erlangen-Nürnberg, Germany
| | - Veronika Engert
- Institute of Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Stoystraße 3, 07743, Jena, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Derycke L, De Roux Q, Mongardon N, Khaled A, Corniquet M, Desgranges P, Touma J. Hypnosis during Endovascular Abdominal Aortic Aneurysm Repair. J Clin Med 2024; 13:979. [PMID: 38398292 PMCID: PMC10889103 DOI: 10.3390/jcm13040979] [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: 12/29/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Endovascular abdominal aneurysm repair (EVAR) is associated with a reduction in early morbidity and mortality compared with open repair. Procedures performed under hypnosis might represent an alternative to further reduce the risks related to general anesthesia (GA). This study aimed to assess the feasibility and safety of hypnosis and local anesthesia during EVAR. (2) Methods: All consecutive patients who underwent EVAR or fenestrated/branched EVAR (f/bEVAR) under hypnosis and local anesthesia (n = 28) between 2017 and 2019 were retrospectively studied and matched to control patients who underwent the same interventions under GA. (3) Results: There was neither a significant difference in the length of ICU stay (p = 0.06), nor in the occurrence of endoleaks, reintervention, and 30-day mortality rate (p = 1.00, 0.73, and 0.24, respectively). The hypnosis group had lower use of norepinephrine (maximum dose 0.04 ± 0.1 vs. 1.2 ± 4.0 mg·h-1, p < 0.001), shorter procedure duration (181.2 ± 71.4 vs. 214.3 ± 79.6 h, p = 0.04), and shorter length of stay (5.4 ± 3.2 vs. 8.4 ± 5.9 days, p = 0.002). (4) Conclusions: In this pioneering study, hypnosis during EVAR appears feasible and safe. It is associated with lower intraoperative use of norepinephrine, as well as procedure duration and length of in-hospital stay.
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Affiliation(s)
- Lucie Derycke
- Service de Chirurgie Vasculaire, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France; (L.D.); (M.C.); (P.D.)
- Faculté de Santé, Université Paris Est Créteil, F-94010 Créteil, France; (Q.D.R.); (N.M.)
| | - Quentin De Roux
- Faculté de Santé, Université Paris Est Créteil, F-94010 Créteil, France; (Q.D.R.); (N.M.)
- Service d’Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France;
- U955-IMRB, Equipe 03 “Pharmacologie et Technologies pour les Maladies Cardiovasculaires (PROTECT)”, Inserm, Université Paris Est Créteil (UPEC), Ecole Nationale Vétérinaire d’Alfort (EnVA), F-94700 Maisons-Alfort, France
| | - Nicolas Mongardon
- Faculté de Santé, Université Paris Est Créteil, F-94010 Créteil, France; (Q.D.R.); (N.M.)
- Service d’Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France;
- U955-IMRB, Equipe 03 “Pharmacologie et Technologies pour les Maladies Cardiovasculaires (PROTECT)”, Inserm, Université Paris Est Créteil (UPEC), Ecole Nationale Vétérinaire d’Alfort (EnVA), F-94700 Maisons-Alfort, France
| | - Asmaa Khaled
- Service d’Anesthésie-Réanimation Chirurgicale, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France;
| | - Marie Corniquet
- Service de Chirurgie Vasculaire, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France; (L.D.); (M.C.); (P.D.)
| | - Pascal Desgranges
- Service de Chirurgie Vasculaire, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France; (L.D.); (M.C.); (P.D.)
- Faculté de Santé, Université Paris Est Créteil, F-94010 Créteil, France; (Q.D.R.); (N.M.)
| | - Joseph Touma
- Service de Chirurgie Vasculaire, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, F-94010 Créteil, France; (L.D.); (M.C.); (P.D.)
- Faculté de Santé, Université Paris Est Créteil, F-94010 Créteil, France; (Q.D.R.); (N.M.)
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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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Rosenbloom BN, Slepian PM, Azam MA, Aternali A, Birnie KA, Curtis K, Thaker S, Ladak S, Waisman A, Clarke H, Katz J, Weinrib AZ. A Randomized Controlled Trial of Clinical Hypnosis as an Opioid-Sparing Adjunct Treatment for Pain Relief in Adults Undergoing Major Oncologic Surgery. J Pain Res 2024; 17:45-59. [PMID: 38196969 PMCID: PMC10775151 DOI: 10.2147/jpr.s424639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 11/27/2023] [Indexed: 01/11/2024] Open
Abstract
Clinical hypnosis is an effective strategy for managing acute pain in the surgical setting. However, the opioid sparing effects of clinical hypnosis are not as well understood. This pre-registered (NCT03730350) randomized, controlled trial (RCT) examined the impact of clinical hypnosis, pre- and post-surgery, on opioid consumption during hospitalization as well as on measures of pain intensity, pain interference, depressed mood, anxiety, sleep, and pain catastrophizing. Participants (M = 57.6 years; SD = 10.9) awaiting oncologic surgery were randomized to treatment-as-usual (n = 47) or hypnosis (n = 45). Intent-to-treat analyses were conducted using linear mixed effects modeling. A significant Group × Time interaction, F(6, 323.34) = 3.32, p = 0.003, indicated an opioid sparing effect of clinical hypnosis during the acute postoperative period. Hypnosis also protected against increases in pain catastrophizing at one-week after surgery, F (1, 75.26) = 4.04, p = 0.048. A perioperative clinical hypnosis intervention had a sparing effect on opioid consumption in-hospital after major oncologic surgery. These findings extend the efficacy of clinical hypnosis as an adjunct tool for perioperative pain management.
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Affiliation(s)
- Brittany N Rosenbloom
- Department of Psychology, York University, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Toronto Academic Pain Medicine Institute, Women’s College Hospital, Toronto, ON, Canada
| | - P Maxwell Slepian
- Department of Psychology, York University, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Muhammed Abid Azam
- Department of Psychology, York University, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Andrea Aternali
- Department of Psychology, York University, Toronto, ON, Canada
| | - Kathryn A Birnie
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Kathryn Curtis
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Sonal Thaker
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Salima Ladak
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
| | - Anna Waisman
- Department of Psychology, York University, Toronto, ON, Canada
| | - Hance Clarke
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Joel Katz
- Department of Psychology, York University, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada
| | - Aliza Z Weinrib
- Department of Psychology, York University, Toronto, ON, Canada
- Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, Toronto, ON, Canada
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11
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Schmidt B. Hypnose als Chance für die Anästhesie. Anasthesiol Intensivmed Notfallmed Schmerzther 2024; 59:59-63. [PMID: 38190827 DOI: 10.1055/a-2044-8428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Patients undergoing challenging medical procedures often suffer from high levels of anxiety and stress. Their most important need is a feeling of control and safety. Hypnotic communication provides a means of addressing these feelings without medication. The core technique is to use the perceived stimuli, like beeping sounds or the pressure of the ventilation mask and re-evaluate them as helpful signs. For example, the beeping sounds can be an indicator of the optimal treatment with the highest level of medical equipment in the intensive care unit and the pressure of the ventilation mask might feel like a tight hug of a friend that wants to help. Positive suggestions work even better when patients are in a trance state. In the intensive care unit, you can use the natural trance state instead of inducing a formal hypnotic trance. Positive suggestions can even help to prevent negative emotions before the challenging medical procedure starts. It greatly improves patients' well-being to replace common phrases in the everyday medical practice. This article gives examples of better phrasings and elaborates the scientific evidence of positive suggestions that can even stop bleeding. The goal is to show simple ways to improve communication with patients and induce feelings of control and safety.
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12
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Kothari DS, Nieri CA, Tanenbaum ZG, Linker LA, Rangarajan SV. Mind-Body Therapies in the Management of Otolaryngologic Disease: A State-of-the-Art Review of Randomized Controlled Trials. Otolaryngol Head Neck Surg 2024; 170:45-60. [PMID: 37712305 DOI: 10.1002/ohn.523] [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: 09/27/2022] [Revised: 08/18/2023] [Accepted: 08/26/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVE To review and assess the peer-reviewed literature on the utility of mind-body therapy (MBT) as an adjunct treatment in the management of otolaryngologic disease. DATA SOURCES PubMed, Embase, and Cochrane. REVIEW METHODS Randomized control trials (RCTs) of MBTs in the management of otolaryngologic disease from 2002 to 2022 were identified and included according to predefined criteria. Interventions requiring expensive equipment were excluded because the goal of MBT is to be cost-conscious. All studies were subjected to a two-stage blinded screening, extraction, and appraisal process. The outcomes of the intervention and control groups were compared. CONCLUSION RCTs of MBTs, including breathing exercises (4), aromatherapy (2), biofeedback (2), meditation, (2), and yoga (2), have been studied in several otolaryngologic conditions, including septoplasty/rhinoplasty (3), head and neck cancer (2), facial palsy (2), and tinnitus (2). Most studies were of moderate risk of bias on appraisal, and each MBT studied was found to significantly reduce subjective and objective distress associated with the otolaryngologic condition in question. IMPLICATIONS FOR PRACTICE Despite a paucity of strong evidence supporting the universal use of MBTs, our review suggests that MBTs are cost-effective and easily deployable complementary tools in the management of otolaryngologic disease. Future large, methodologically rigorous RCTs are needed to address the limitations of the included studies, such as improper blinding and inappropriate statistical analysis. As MBTs are studied further, a case for their current use can be made because of their low cost and minimal risk to patients.
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Affiliation(s)
- Dhruv S Kothari
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Chad A Nieri
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Zachary G Tanenbaum
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Lauren A Linker
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sanjeet V Rangarajan
- Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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13
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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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14
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Zaccarini S, Fernandez A, Wolff A, Magnusson L, Rehberg-Klug B, Grape S, Schoettker P, Berna C. Hypnosis in the operating room: are anesthesiology teams interested and well-informed? BMC Anesthesiol 2023; 23:287. [PMID: 37620788 PMCID: PMC10464071 DOI: 10.1186/s12871-023-02229-3] [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: 05/22/2023] [Accepted: 08/01/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Hypnosis can be a beneficial complementary anesthesia technique for a variety of surgical procedures. Despite favorable scientific evidence, hypnosis is still rarely used in the operating room. Obstacles to implementation could be a lack of interest or training, misconceptions, as well as limited knowledge amongst anesthesiology teams. Hence, this study aimed to assess the interest, training, beliefs, and knowledge about hypnosis in the operating room staff. DESIGN A questionnaire with 21-items, based on a prior survey, was set up on an online platform. The medical and nursing anesthesiology staff of four Swiss academic and large regional hospitals (N = 754) were invited to participate anonymously through e-mails sent by their hierarchy. Results were analyzed quantitatively. RESULTS Between June, 2020 and August, 2021 353 answers were collected (47% response rate). Most (92%) were aware that hypnosis needs specific training, with 14% trained. A large majority of the untrained staff wished to enroll for conversational hypnosis training. There was a strong agreement for hypnosis playing a role in anesthesia. Nevertheless, many of these professionals believed that hypnosis has a limited field of action (53%) or that it would be too time consuming (33%). The reduction of misconceptions was based more on exposure to hypnosis than on training. CONCLUSION Overall, anesthesia providers' attitude was in favor of using hypnosis in the operating room. Misconceptions such as a prolongation of the procedure, alteration of consent, lack of acceptability for patients, and limited indications were identified as potential barriers. These deserve to be challenged through proper dissemination of the recent scientific literature and exposure to practice.
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Affiliation(s)
- Sonia Zaccarini
- Center for Complementary and Integrative Medicine, Department of Anesthesiology, Lausanne University Hospital (CHUV), and Lausanne University, Rue du Bugnon 46, Lausanne, 1011, Switzerland
- Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Aurore Fernandez
- Center for Complementary and Integrative Medicine, Department of Anesthesiology, Lausanne University Hospital (CHUV), and Lausanne University, Rue du Bugnon 46, Lausanne, 1011, Switzerland.
- Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
| | - Adriana Wolff
- Department of Anesthesiology, University of Geneva Hospitals, Geneva, Switzerland
| | - Lennart Magnusson
- Department of Anesthesiology, Cantons Hospital of Fribourg, Fribourg, Switzerland
| | - Benno Rehberg-Klug
- Department of Anesthesiology, University of Geneva Hospitals, Geneva, Switzerland
| | - Sina Grape
- Department of Anesthesiology, Valais Hospital, Sion, Switzerland
| | - Patrick Schoettker
- Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Chantal Berna
- Center for Complementary and Integrative Medicine, Department of Anesthesiology, Lausanne University Hospital (CHUV), and Lausanne University, Rue du Bugnon 46, Lausanne, 1011, Switzerland
- Pain Center, Department of Anesthesiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
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15
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Sola C, Devigne J, Bringuier S, Pico J, Coruble L, Capdevila X, Captier G, Dadure C. Hypnosis as an alternative to general anaesthesia for paediatric superficial surgery: a randomised controlled trial. Br J Anaesth 2023; 130:314-321. [PMID: 36690538 DOI: 10.1016/j.bja.2022.11.023] [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: 08/02/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Reducing perioperative anxiety and controlling pain in children are essential to optimise recovery and outcomes for both children and their parents. By acting on sensory and affective modulation of anxiety and pain, hypnosis is widely used in medical care, especially in anaesthesia. This randomised controlled clinical trial was designed to compare general anaesthesia and intraoperative hypnosis support for perioperative management of children undergoing superficial surgery. METHODS Children aged 7-16 yr scheduled for day-case superficial surgery were included and randomly assigned to one of the following two groups: general anaesthesia group or hypnosis group. The primary outcome was length of hospital stay. Child and parent anxiety, child pain, and the occurrence of postoperative negative behavioural changes were also evaluated. RESULTS Sixty children of mean age 10.3 (standard deviation: 2.6) yr were enrolled in the study. Hypnosis was successful in all but one case. The median (25th-75th percentile) length of hospital stay was shorter in the hypnosis group (120 [95-145] vs 240.5 [218-275] min; P<0.001). The general anaesthesia group was associated with a greater incidence of high levels of preoperative anxiety in children (30 vs 11%; P=0.001) and parents (55 vs 30%; P=0.05). Pain scores did not differ between groups. No negative postoperative behavioural changes were reported. CONCLUSIONS In children aged 7-16 yr, hypnosis appears to be feasible and accepted. The quality of the perioperative experience and the rapid recovery support the use of hypnosis as an effective and safe alternative to general anaesthesia for paediatric superficial surgery. CLINICAL TRIAL REGISTRATION NCT02505880.
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Affiliation(s)
- Chrystelle Sola
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.
| | - Julie Devigne
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France
| | - Sophie Bringuier
- Department of Anaesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France
| | - Julien Pico
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Lucie Coruble
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France
| | - Xavier Capdevila
- Department of Anaesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France; Montpellier Neurosciences Institute, Montpellier University Hospital, Montpellier, France
| | - Guillaume Captier
- Department of Paediatric Plastic Surgery, Montpellier University Hospital, Montpellier, France
| | - Christophe Dadure
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
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16
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Complementary Therapy Learning in the Setting of Lung Transplantation: A Single-Center Observational Study of Appropriation and Efficacy. J Clin Med 2023; 12:jcm12051722. [PMID: 36902509 PMCID: PMC10002550 DOI: 10.3390/jcm12051722] [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: 01/03/2023] [Revised: 02/11/2023] [Accepted: 02/15/2023] [Indexed: 02/25/2023] Open
Abstract
Transplanted patients could benefit from complementary techniques. This prospective single-center, open study, performed in a tertiary university hospital, evaluates the appropriation and efficacy of a toolbox-kit of complementary techniques. Self-hypnosis, sophrology, relaxation, holistic gymnastics, and transcutaneous electric nerve stimulation (TENS) were taught to adult patients scheduled for double-lung transplantation. Patients were asked to use them before and after transplantation, as needed. The primary outcome was appropriation of each technique within the first three postoperative months. Secondary outcomes included efficacy on pain, anxiety, stress, sleep, and quality-of-life. Among the 80 patients included from May 2017 to September 2020, 59 were evaluated at the 4th postoperative month. Over the 4359 sessions performed, the most frequent technique used before surgery was relaxation. After transplantation, the techniques most frequently used were relaxation and TENS. TENS was the best technique in terms of autonomy, usability, adaptation, and compliance. Self-appropriation of relaxation was the easiest, while self-appropriation of holistic gymnastics was difficult but appreciated by patients. In conclusion: the appropriation by patients of complementary therapies such as mind-body therapies, TENS and holistic gymnastics is feasible in lung transplantation. Even after a short training session, patients regularly practiced these therapies, mainly TENS and relaxation.
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17
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A neurophenomenological approach to non-ordinary states of consciousness: hypnosis, meditation, and psychedelics. Trends Cogn Sci 2023; 27:139-159. [PMID: 36566091 DOI: 10.1016/j.tics.2022.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022]
Abstract
No contemporary unifying framework has been provided for the study of non-ordinary states of consciousness (NSCs) despite increased interest in hypnosis, meditation, and psychedelics. NSCs induce shifts in experiential contents (what appears to the experiencer) and/or structure (how it appears). This can allow the investigation of the plastic and dynamic nature of experience from a multiscale perspective that includes mind, brain, body, and context. We propose a neurophenomenological (NP) approach to the study of NSCs which highlights their role as catalysts of transformation in clinical practice by refining our understanding of the relationships between experiential (subjective) and neural dynamics. We outline the ethical implications of the NP approach for standard conceptions of health and pathology as well as the crucial role of experience-based know-how in NSC-related research and application.
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18
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Orewa H, Udo I. Hypnotherapy and therapeutic suggestion: bridging the gap between evidence and utility. BJPSYCH ADVANCES 2022. [DOI: 10.1192/bja.2022.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SUMMARY
The use of hypnotherapy in psychiatry has been controversial. However, evidence presented by Chan and colleagues shows that it is beneficial to the promotion of good mental health and well-being, specifically being applicable in the management of mental disorders. But what does this mean for practice? This commentary looks at what we agree and disagree with, what we opine is missing from the article and what now needs to happen. Patients should be able to access hypnotherapy or hypnosis routinely on the National Health Service. Since it works, who may it work for and how may we make this available to those who could benefit from it?
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19
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Nowak H, Wolf A, Rahmel T, Oprea G, Grause L, Moeller M, Gyarmati K, Mittler C, Zagler A, Lutz K, Loeser J, Saller T, Tryba M, Adamzik M, Hansen E, Zech N. Therapeutic Suggestions During General Anesthesia Reduce Postoperative Nausea and Vomiting in High-Risk Patients – A Post hoc Analysis of a Randomized Controlled Trial. Front Psychol 2022; 13:898326. [PMID: 35910976 PMCID: PMC9337244 DOI: 10.3389/fpsyg.2022.898326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/16/2022] [Indexed: 12/14/2022] Open
Abstract
Postoperative nausea and vomiting (PONV) are one of the most adverse events after general anesthesia, a distressing experience, and pose a risk to the patient. Despite advances in drug prophylaxis and PONV treatment, the incidence remains high and additional non-pharmacological treatments are needed. In this post hoc analysis of a recently published double-blind multicenter randomized controlled trial on the efficacy of intraoperative therapeutic suggestions on postoperative opioid dosage, we analyzed the effects of intraoperative therapeutic suggestions on PONV. We focus on patients with a high risk of PONV (Apfel risk score of 3–4) and distinguished early (first two postoperative hours) and delayed PONV (2–24 h). A total of 385 patients with a moderate or high risk for PONV were included. The incidence of early and delayed PONV was reduced (22.7–18.3 and 29.9–24.1%, respectively), without statistical significance, whereas in high-risk patients (n = 180) their incidence was nearly halved, 17.2 vs. 31.2% (p = 0.030) and 20.7 vs. 34.4% (p = 0.040), corresponding to a number needed to treat of 7 to avoid PONV. In addition, there was a significant reduction in PONV severity. In a multivariate logistic regression model, assignment to the control group (OR 2.2; 95% CI: 1.1–4.8) was identified as an independent predictor of the occurrence of early PONV. Our results indicate that intraoperative therapeutic suggestions can significantly reduce the incidence of PONV in high-risk patients. This encourages the expansion of therapeutic suggestions under general anesthesia, which are inexpensive and virtually free of side effects. Clinical Trial Registration: German Clinical Trials Register, https://drks.de, registration number: 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
- *Correspondence: Hartmuth Nowak,
| | - Alexander Wolf
- 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
| | - 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
| | | | - 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
| | - Alexandra Zagler
- Department of Anesthesiology, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Katrin Lutz
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
| | - Johannes Loeser
- Department of Anesthesiology and Intensive Care Medicine, University Hospital, University of Cologne, Cologne, Germany
| | - Thomas Saller
- Department of Anesthesiology, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Michael Tryba
- Kassel School of Medicine, Kassel, Germany
- Clinic for Anesthesiology, Intensive Care Medicine, Emergency Medicine and Pain Therapy, Kassel Hospital, Kassel, Germany
| | - Michael Adamzik
- Department of Anesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Ernil Hansen
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
| | - Nina Zech
- Department of Anesthesiology, University Hospital Regensburg, University of Regensburg, Regensburg, Germany
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20
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Böhmer J, Schmidt B. Safety on demand: Post-hypnotic suggestions of safety reduce neural signals of reward sensitivity with long-term beneficial effects. Psychophysiology 2022; 59:e14015. [PMID: 35103984 DOI: 10.1111/psyp.14015] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 10/19/2021] [Accepted: 01/07/2022] [Indexed: 12/16/2022]
Abstract
Increased reward sensitivity has been proposed as an important transdiagnostic feature for a series of disorders, including addictive behaviors. Earlier studies suggest that a positive affective state characterized by the feeling of safety could reduce an individual's reward sensitivity. A promising technique to establish a feeling of safety on demand is to utilize post-hypnotic suggestions. We hypothesized that the feeling of safety elicited by post-hypnotic suggestions reduces neural signals of reward sensitivity. To test our predictions, we hypnotized 24 highly suggestible participants, suggested them to feel safe and coupled this feeling of safety to a post-hypnotic trigger that reactivates the feeling of safety outside the hypnotic state. Participants then played a risk game both in a safety condition using the post-hypnotic safety trigger and in a control condition using a neutral trigger. Simultaneously, we recorded their EEG. Participants reported significantly higher ratings of safety in the safety condition compared to the control condition. Even several weeks after the main experimental session, the post-hypnotic safety trigger still elicited a significantly stronger feeling of safety compared to the control condition. Moreover, the Reward Positivity (RewP) was significantly reduced in the safety condition. As the RewP amplitude has been proposed as a psychophysiological marker for reward sensitivity, we conclude that the suggestion of safety by post-hypnotic suggestions turns participants into a quiescence motivational state that makes them less reward sensitive. Therefore, we discuss implications of the post-hypnotic safety trigger for the treatment of disorders associated with increased reward sensitivity such as addictive behaviors.
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Affiliation(s)
- Justin Böhmer
- Institute of Psychology, University of Jena, Jena, Germany
| | - Barbara Schmidt
- Institute of Psychology, University of Jena, Jena, Germany.,Institute for Psychosocial Medicine, Psychotherapy and Psychooncology, Jena University Hospital, Jena, Germany
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Ambrose K, Simpson K, Adams D. The relationship between social and academic outcomes and anxiety for children and adolescents on the autism spectrum: A systematic review. Clin Psychol Rev 2021; 90:102086. [PMID: 34598053 DOI: 10.1016/j.cpr.2021.102086] [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: 07/05/2020] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 12/28/2022]
Abstract
Anxiety is the most common co-occurring condition in children on the autism spectrum but the potential impacts of anxiety on social and academic outcomes of children on the autism spectrum have not been systematically examined. In this review, 50 studies were identified that explore the relationship between anxiety and scores on social or academic measures in children on the autism spectrum. Social competence was frequently measured, and the findings of these studies were mixed. While other social constructs have received little attention, associations were found between anxiety and victimisation, and anxiety and social relationships. Only three studies focused on the impact of anxiety on scores on academic measures, highlighting the need for further research in this area. Anxiety was most frequently measured using subscales from broader behavioural instruments, which may not capture the range of anxiety symptoms of children on the autism spectrum. Future studies that include multi-informant methodologies and proportional representation of females and children with intellectual disability will further knowledge of the impact of anxiety in children on the spectrum.
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Affiliation(s)
- Kathryn Ambrose
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia.
| | - Kate Simpson
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia
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