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Inthasot V, Taton O, Bondue B, Van Muylem A, Leduc D. [The effects of hypnosis by virtual reality on tolerance to flexible bronchoscopy]. Rev Mal Respir 2023; 40:555-563. [PMID: 37635020 DOI: 10.1016/j.rmr.2023.05.004] [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: 03/09/2023] [Accepted: 05/16/2023] [Indexed: 08/29/2023]
Abstract
INTRODUCTION Patients often perceive flexible bronchoscopy as an unpleasant procedure. The aim of this study was to investigate the effect of virtual reality (VR) hypnosis on tolerance to flexible bronchoscopy. MATERIALS AND METHODS We conducted a prospective, randomized, controlled, monocentric study comparing flexible bronchoscopy with VR-induced hypnosis to the usual procedure. Patient tolerance was evaluated using a visual analogue scale (VAS), the state-trait anxiety inventory (STAI) before and after the procedure and, finally, willingness to repeat the examination under the same conditions (WTR). RESULTS Among the 70 patients included, 34 were randomized to the VR hypnosis group and 36 to the control group. There was no difference between the 2 groups in terms of modification of the pre-/post-bronchoscopy VAS for anxiety, pain, cough, choking, nausea and overall discomfort, or modification of the STAI score and WTR. Subgroup analysis among patients who were more anxious before the procedure revealed a trend toward reduced anxiety in the VR hypnosis group. CONCLUSION This study did not observe any effect of VR hypnosis on the tolerance of patients during routine flexible bronchoscopy. However, VR hypnosis may be beneficial in patients with higher anxiety score before bronchoscopy, a hypothesis that needs to be confirmed by further studies with a larger number of subjects.
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Affiliation(s)
- V Inthasot
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique; Service de pneumologie, Centre Hospitalier Universitaire Brugmann, Université Libre de Bruxelles, Bruxelles, Belgique.
| | - O Taton
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - B Bondue
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - A Van Muylem
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
| | - D Leduc
- Service de pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique
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Lemoine L, Adam V, Galus X, Siles P, Coulon A, Grenier-Desforges J, Orabona J, Kergastel I, Wagner P, Salleron J, Tosti P, Huin-Schohn C, Merlin JL, Etienne R, Henrot P. Conversational hypnosis versus standard of care to reduce anxiety in patients undergoing marker placement under radiographic control prior to breast cancer surgery: A randomized, multicenter trial. Front Psychol 2022; 13:971232. [PMID: 36483698 PMCID: PMC9724617 DOI: 10.3389/fpsyg.2022.971232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 11/03/2022] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Surgery is a cornerstone of breast cancer management. Prior to surgery, a wire marker is placed at the site of the tumor, to enable the surgeon to accurately localize the lesion during later surgery. This procedure can generate considerable anxiety for many patients. We investigated the value of conversational hypnosis (CH) in reducing anxiety in patients undergoing preoperative wire placement under radiographic control. METHODS Randomized, multicentre study in 7 centers in France. Inclusion criteria were patients aged >18 years with an Eastern Cooperative Oncology Group performance status ≤2, scheduled to undergo preoperative wire placement in one or several breast lesions. Patients were randomized in a 1:1 ratio, stratified by center to undergo preoperative wire placement with or without the use of CH by a radiological technician trained in the CH technique. The primary endpoint was the percentage of patients with an anxiety score ≥ 6 on a visual analog scale ranging from 0 (absence of anxiety) to 10 (maximal anxiety). Secondary endpoints were pain score, perceived duration reported by the patient, technician satisfaction with their relationship with the patient, and ease of marker insertion reported by the radiologist. Semi-structured interviews were performed with patients to assess their perception of the marker placement procedure. RESULTS The trial was prematurely interrupted for futility after a planned interim analysis after accrual of 167 patients, i.e., half the planned sample size. Prior to marker placement, 29.3% (n = 24) of patients in the control group had an anxiety score ≥ 6, versus 42.3% (n = 33) in the CH group (p = 0.08). After marker placement, the change of anxiety score was not significantly different between groups (11.0% (n = 9) versus 14.3% (n = 11), p = 0.615). There was no significant difference in any of the secondary endpoints. In the interviews, patients from both groups frequently spoke of a feeling of trust. CONCLUSION This study failed to show a benefit of conversational hypnosis on anxiety in patients undergoing marker placement prior to surgery for breast cancer. The fact that some caregivers had learned this personalized therapeutic communication technique may have had a positive impact on the whole caregiving team. TRIAL REGISTRATION The study was registered with ClinicalTrials.gov (NCT02867644).
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Affiliation(s)
- Lydie Lemoine
- Department of Radiology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Virginie Adam
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Xavier Galus
- Department of Radiology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Pascale Siles
- Department of Radiology, Centre Hospitalier Universitaire la Timone, Marseille, France
| | - Agnès Coulon
- Department of Radiology, Centre Léon Bérard, Lyon, France
| | | | - Joseph Orabona
- Department of Radiology, Centre Hospitalier de Bastia, Institut du Sein, Bastia, France
| | - Isabelle Kergastel
- Department of Radiology, Centre Hospitalier Universitaire de Brest, Brest, France
| | - Pierre Wagner
- Department of Radiology, Centre Paul Strauss, Strasbourg, France
| | - Julia Salleron
- Departement of Biostatistics, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Priscillia Tosti
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Cécile Huin-Schohn
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Jean-Louis Merlin
- Departement of Clinical Research, Institut de Cancérologie de Lorraine, Université de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Rémi Etienne
- Department of Supportive Care in Oncology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
| | - Philippe Henrot
- Department of Radiology, Institut de Cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France
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Tran LC, Coopman S, Rivallain C, Aumar M, Guimber D, Nicolas A, Darras V, Turck D, Gottrand F, Ley D. Use of Hypnosis in Paediatric Gastrointestinal Endoscopy: A Pilot Study. Front Pediatr 2021; 9:719626. [PMID: 34631620 PMCID: PMC8492983 DOI: 10.3389/fped.2021.719626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Experience of hypnosis in gastrointestinal (GI) endoscopy is scarce in children. Our aims were to assess the rate of successful GI endoscopy performed using hypnosis alone or in combination with midazolam, with or without additional equimolar mixture of oxygen and nitrous oxide (EMONO), and to identify predictive factors of successful endoscopy in children. Methods: This prospective single-centre study included children older than 6 years requiring a diagnostic esophagogastroduodenoscopy (EGD) or rectosigmoidoscopy. Ericksonian hypnosis was performed alone or in combination with midazolam, with or without additional EMONO. Successful endoscopy was defined by a complete and well-tolerated procedure. Levels of satisfaction of the endoscopist, nurse, and patient were assessed. Results: One hundred forty children [70 boys, median age: 12 years (Q1-Q3: 9-14)] were included over a 14-month period. They underwent EGD in 51.4% (n = 72) and rectosigmoidoscopy in 48.6% (n = 68) of cases. EMONO and midazolam were combined with hypnosis in 136 cases (97.1%). Successful endoscopy rate reached 82.9%. The procedure was interrupted due to poor tolerance and was rescheduled under general anaesthesia in 11 patients (7.9%). Predictive factors for successful endoscopy were older age (13 vs. 8 years, OR: 1.34, CI 95% [1.10-1.62], p = 0.003) and type of endoscopy (EGD vs. rectosigmoidoscopy, OR: 16.34 [2.14-124.68], p = 0.007). A good cooperation of the patient was reported by the endoscopist and the nurse in 88.4 and 86.9% of cases, respectively. Ninety-two per cent of patients mentioned that the procedure went well. Conclusions: Our study suggests that hypnosis combined with EMONO and/or midazolam is of additional value to perform diagnostic EGD or rectosigmoidoscopy in children older than 6 years without systematic need for general anaesthesia.
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Affiliation(s)
- Léa Chantal Tran
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France
| | - Stéphanie Coopman
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Céline Rivallain
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Madeleine Aumar
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Dominique Guimber
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Audrey Nicolas
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Valérie Darras
- Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Dominique Turck
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Frédéric Gottrand
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
| | - Delphine Ley
- Univ. Lille, Inserm, CHU Lille, U1286 - INFINITE - Institute for Translational Research in Inflammation, Lille, France.,Division of Gastroenterology, Hepatology and Nutrition, Department of Paediatrics, Jeanne de Flandre Children's Hospital, CHU Lille and Univ. Lille, Lille, France
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Hormati A, Aminnejad R, Saeidi M, Ghadir MR, Mohammadbeigi A, Shafiee H. Prevalence of Anesthetic and Gastrointestinal Complications of Endoscopic Retrograde Cholangiopancreatography. Anesth Pain Med 2019; 9:e95796. [PMID: 31754612 PMCID: PMC6825367 DOI: 10.5812/aapm.95796] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 07/30/2019] [Accepted: 08/06/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Endoscopic retrograde cholangiopancreatography (ERCP) is an endoscopic method for treatment of many biliary diseases. With respect to rapid recovery and more patient comfort, this procedure is currently performed under light general anesthesia (GA) or conscious sedation. OBJECTIVES The current study aimed to clarify that intravenous sedation or light general anesthesia can be performed without great fear of anesthesia related complications in ERCP patients and sedative doses of propofol can be used safely in outpatient settings under the supervision of an expert anesthesiologist. METHODS This is a cross-sectional study on 1023 ERCP patients under light GA during 2014 - 2018 in Qom, Shahid Beheshti Hospital. Data were collected by a checklist and were analyzed by using chi-square test in SPSS V.22. RESULTS From 1023 patients, 501 (48.97 %) were male and 522 (51.03 %) were female with a mean age of 47.2 ± 6.7 years. The most common finding in ERCP was choledocholithiasis (76.15 %). The most common complication was hemodynamic instability (37.01 %) followed by desaturation (11.65 %) both of them ware anesthesia related. Prevalence of GI (gastrointestinal) related complications was 13.39 %. The most common GI related complications were pancreatitis (7.92 %) and bleeding (3.32 %). Total mortality rate was 0.88 %. CONCLUSIONS ERCP-related complications are inevitable but can be controlled by early diagnosis and clinical experience. Severe complications and high risk patients may increase the mortality and morbidity of the procedure. Anesthesia related complications are more frequent than GI related unwanted events. Fortunately, the most common anesthesia related complications are readily manageable and are minor in nature when an expert anesthesiologist is present in the scene. Close monitoring of the patient's vital signs should be the mainstay of the safe procedure.
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Affiliation(s)
- Ahmad Hormati
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
- Gastrointestinal and Liver Disease Research Center, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Aminnejad
- Department of Anesthesiology and Critical Care, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Saeidi
- Department of Anesthesiology and Critical Care, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Reza Ghadir
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Abolfazl Mohammadbeigi
- Gastroenterology and Hepatology Disease Research Center, Qom University of Medical Sciences, Qom, Iran
| | - Hamed Shafiee
- Department of Anesthesiology and Critical Care, Qom University of Medical Sciences, Qom, Iran
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Boselli E, Musellec H, Bernard F, Guillou N, Hugot P, Augris-Mathieu C, Diot-Junique N, Bouvet L, Allaouchiche B. EFFECTS OF CONVERSATIONAL HYPNOSIS ON RELATIVE PARASYMPATHETIC TONE AND PATIENT COMFORT DURING AXILLARY BRACHIAL PLEXUS BLOCKS FOR AMBULATORY UPPER LIMB SURGERY:A Quasiexperimental Pilot Study. Int J Clin Exp Hypn 2018; 66:134-146. [PMID: 29601275 DOI: 10.1080/00207144.2018.1421355] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This two-center quasiexperimental pilot study was to determine the effect of conversational hypnosis on patient comfort and parasympathetic tone, which may represent a quantitative measure of hypnotic depth, during regional anesthesia. The patients received conversational hypnosis in one center and oral premedication in the other. The patients' subjective comfort (0-10 rating scale) and objective parasympathetic tone, as assessed by the Analgesia/Nociception Index (ANI), were measured before and after regional anesthesia. The parasympathetic tone and comfort scores evidenced a significantly greater increase in the hypnosis patients than in controls. These findings suggest that using conversational hypnosis during regional anesthesia may be followed by a subjective increase in patient comfort and an objective increase in parasympathetic tone, monitored by ANI.
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Affiliation(s)
- Emmanuel Boselli
- a University of Lyon, University Lyon I Claude Bernard, APCSe VetAgroSup UPSP 2016.A101 , Lyon , France
| | - Hervé Musellec
- c Centre hospitalier privé Saint-Grégoire , Saint-Grégoire , France
| | - Franck Bernard
- c Centre hospitalier privé Saint-Grégoire , Saint-Grégoire , France
| | - Nicolas Guillou
- c Centre hospitalier privé Saint-Grégoire , Saint-Grégoire , France
| | - Pierre Hugot
- c Centre hospitalier privé Saint-Grégoire , Saint-Grégoire , France
| | | | | | - Lionel Bouvet
- a University of Lyon, University Lyon I Claude Bernard, APCSe VetAgroSup UPSP 2016.A101 , Lyon , France
| | - Bernard Allaouchiche
- a University of Lyon, University Lyon I Claude Bernard, APCSe VetAgroSup UPSP 2016.A101 , Lyon , France
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Fathi M, Aziz Mohammadi S, Moslemifar M, Kamali K, Joudi M, Sabri Benhangi A, Mohaddes M, Joudi M, Mohajeri M. Hypnoanalgesia for Dilatation and Curettage Pain Control. Anesth Pain Med 2017; 7:e44628. [PMID: 28824863 PMCID: PMC5556399 DOI: 10.5812/aapm.44628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/03/2017] [Accepted: 01/18/2017] [Indexed: 11/17/2022] Open
Abstract
There are many acceptable approaches ranging from light to moderate intravenous sedation or analgesic drugs that are used to provide pain control in dilatation and curettage. We report the use of hypnosis as a nonpharmacologic approach to control pain in this manner.
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Affiliation(s)
- Mehdi Fathi
- Associate Professor of Cardiac Anesthesia, Mashhad University of Medical Sciences, Iranian Scientific Society of Clinical Hypnosis, Mashhad, Iran
| | | | - Mehdi Moslemifar
- Psychologist, Hajar Hospital, Iranian Scientific Society of Clinical Hypnosis, Tehran, Iran
| | - Kurosh Kamali
- Psychologist, Hajar Hospital, Iranian Scientific Society of Clinical Hypnosis, Tehran, Iran
| | - Marjan Joudi
- Assistant Professor of Surgery, Mashhad University of Medical Sciences, Mashhad, Iran
- Corresponding author: Marjan Joudi, Assistant Professor of Surgery, Mashhad University of Medical Sciences, Mashhad, Iran. E-mail:
| | - Azam Sabri Benhangi
- Resident of Anesthesia, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Mohaddes
- Resident of Anesthesia, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Joudi
- Assistant Professor of Radiotherapy, Mashhad University of Medical Sciences, Mashhad, Iran
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