Hypnosis associated with local anesthesia versus local anesthesia alone during bone marrow biopsy: a randomized,...

Area of Science:

• Hematology
• Medical Procedures
• Psychological Interventions

Background:

• Bone marrow biopsy (BMB) is crucial for diagnosing and staging hematological diseases.
• Patients often experience significant anxiety and pain during BMB, even with standard pain management.
• Hypnosis is a non-pharmacological method being explored to mitigate procedural distress.

Purpose of the Study:

• To evaluate the efficacy of adding hypnosis to local anesthesia (LA + H) for improving patient comfort during BMB.
• To compare patient comfort during BMB with LA + H versus LA alone.
• To assess secondary outcomes including pain, anxiety, and practitioner comfort.

Main Methods:

• A prospective, multicenter, randomized, open-label study (QUALHYBOM) involving 180 BMB-naive patients.
• Patients were randomized into two groups: LA alone (n=91) and LA + H (n=89).
• Patient comfort was the primary endpoint, assessed immediately post-procedure on a 0-10 scale; pain and anxiety were secondary outcomes.

Main Results:

• The LA + H group reported significantly higher median comfort scores (9 vs. 5) compared to the LA group (p < 10⁻⁴).
• The LA + H group experienced significantly lower pain (2 vs. 6) and post-procedure discomfort scores (1 vs. 5) (p < 10⁻⁴).
• Practitioner comfort was higher, and the need for equimolar mixture of oxygen and nitrous oxide (EMONO) was lower in the LA + H group (p < 10⁻⁴).

Conclusions:

• Hypnosis, when added to local anesthesia, significantly enhances patient comfort during bone marrow biopsies.
• This non-pharmacological intervention reduces pain and anxiety, improving the overall procedural experience.
• Integrating hypnosis into clinical practice may decrease the reliance on supplementary pharmacological agents for BMB.