Hypnosis Versus Placebo During Atrial Flutter Ablation: The PAINLESS Study: A Randomized Controlled Trial

Area of Science:

• Cardiology
• Pain Management
• Medical Hypnosis

Background:

• Atrial flutter (AFL) ablation often requires opioid analgesia, carrying risks of adverse outcomes.
• Limited robust data exist on hypnosis efficacy in electrophysiological procedures.
• Hypnosis presents a promising alternative for pain management during cardiac ablation.

Purpose of the Study:

• To evaluate the superiority of hypnosis compared to placebo for pain perception during AFL ablation.
• To assess the impact of hypnosis on morphine consumption in patients undergoing AFL ablation.

Main Methods:

• A single-center, randomized controlled trial was conducted.
• 113 patients undergoing AFL ablation were randomized to hypnosis or placebo groups.
• Standard analgesia protocol included intravenous morphine for pain scores ≥5.

Main Results:

• The hypnosis group reported significantly lower mean pain scores (4.0 vs. 5.5, p < 0.001).
• Morphine requirements were substantially reduced in the hypnosis group (1.3 mg vs. 3.6 mg, p < 0.001).
• Patients in the hypnosis group also experienced better sedation scores.

Conclusions:

• Hypnosis is superior to placebo in alleviating pain during AFL ablation.
• Hypnosis effectively reduces opioid requirements in patients undergoing AFL ablation.
• This trial supports hypnosis as a valuable non-pharmacological tool in electrophysiology.