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Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A
Nathalie Duparc-Alegria1, Karine Tiberghien1, Hendy Abdoul2,3
1Pain Management Unit, Department of Anaesthesiology, AP-HP, Hôpital Robert-Debré, Paris, France.
Insights
A short hypnosis session did not significantly reduce postoperative anxiety or pain in pediatric orthopedic surgery patients. Both groups showed reduced anxiety, suggesting other factors like pre-operative interviews may be more impactful.
Area of Science:
- Anesthesiology
- Psychology
- Pediatric Surgery
Background:
- Perioperative anxiety is a significant concern in pediatric surgery, even with pre-operative information.
- Effective management strategies for reducing anxiety and pain are crucial.
Purpose of the Study:
- To evaluate the effect of a brief hypnotic session on postoperative anxiety and pain in children undergoing major orthopedic surgery.
- To compare outcomes between a hypnosis group and a control group.
Main Methods:
- An open-label, single-center randomized clinical study.
- 120 children (aged 10-18 years) were assigned to either a control group or a hypnosis group.
- Postoperative anxiety was the primary endpoint, assessed using a visual analogue scale (VAS).
Main Results:
- No significant difference in postoperative anxiety scores was observed between the hypnosis and control groups (p=0.17).
- Both groups demonstrated a significant reduction in anxiety from pre-surgery to post-surgery (p<0.0001).
- Postoperative pain scores were low and did not differ significantly between the groups (p=0.57).
Conclusions:
- A short pre-induction hypnosis session did not impact postoperative anxiety or pain levels in this pediatric orthopedic surgery cohort.
- The observed decrease in anxiety and pain may be attributed to enhanced pre-operative nurse interviews and improved communication.
- Low baseline anxiety in both groups suggests that pre-operative patient education and communication strategies are vital for managing anxiety.
Aims And Objectives:
To assess the impact of a short hypnotic session on postoperative anxiety and pain in major orthopaedic surgery.
Background:
Despite specific information given before a scheduled paediatric surgery, perioperative anxiety can become important.
Design:
Randomised Clinical Study.
Methods:
The study is an open single-centre randomised clinical study comparing a "control" group versus a "hypnosis" group receiving a short hypnosis pre-induction session as additional experimental analgesic procedure. The primary endpoint was the postoperative anxiety, blindly assessed using a visual analogue scale.
Results:
The study involved 120 children (age 10-18 years). The results showed no difference between control group versus hypnosis group. Twenty-four hours after surgery (Day+1), the patient's anxiety score was not different between control and hypnosis groups (median [Q1-Q3]: 1 [0; 3] vs. 0 [0; 3], respectively, p = .17). Each group experienced a significant decrease in anxiety level between the day before surgery (Day-1) and the day after surgery (Day+1) (median ([Q1-Q3]) difference of the anxiety score: 2 [4; 0] and 2 [4; 0], respectively, p < .0001 in each group). The postoperative pain scores were low and not different between groups (median [Q1-Q3]: 2 [0; 3] in control group vs. 3 [1; 3] in hypnosis group, p = .57).
Conclusion:
This randomised study on a short hypnosis session performed in the operating room prior to a major surgery showed no difference in postoperative anxiety and pain levels. The decrease in anxiety and pain levels may be due to the addition of nurse pre-operative interviews and optimisation in communication in the operating room.
Relevance To Clinical Practice:
As postoperative anxiety level was low in both control and hypnosis groups, nurse pre-operative interviews and nurse training in hypnosis may contribute to the optimisation of global management and decrease the postoperative anxiety level.
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