Slack David, Nelson Lonnie, Patterson David, Burns Stephen, Hakimi Kevin, Robinson Lawrence
Rehabilitation Care Services Electrodiagnostic Clinic, Veterans Affairs Puget Sound Health Care System, Seattle, Washington, USA.
Am J Phys Med Rehabil. 2009 Jan;88(1):21-9. doi: 10.1097/PHM.0b013e31818e00bd.
Our hypothesis was that hypnotic analgesia reduces pain and anxiety during electromyography (EMG).
We performed a prospective randomized, controlled clinical trial at outpatient electrodiagnostic clinics in teaching hospitals. Just before EMG, 26 subjects were randomized to one of three 20-min audio programs: education about EMG (EDU) (n = 8); hypnotic induction without analgesic suggestion (n = 10); or hypnotic induction with analgesic suggestion (n = 8). The blinded electromyographer provided a posthypnotic suggestion at the start of EMG. After EMG, subjects rated worst and average pain and anxiety using visual analog scales.
Mean values for the EDU, hypnotic induction without analgesic suggestion, and hypnotic induction with analgesic suggestion groups were not significantly different (mean +/- SD): worst pain 67 +/- 25, 42 +/- 18, and 49 +/- 30; average pain 35 +/- 26, 27 +/- 14, and 25 +/- 22; and anxiety 44 +/- 41, 42 +/- 23, and 22 +/- 24. When hypnosis groups were merged (n = 18) and compared with the EDU condition (n = 8), average and worst pain and anxiety were less for the hypnosis group than EDU, but this was statistically significant only for worst pain (hypnosis, 46 +/- 24 vs. EDU, 67 +/- 35; P = 0.049) with a 31% average reduction.
A short hypnotic induction seems to reduce worst pain during electromyography.
我们的假设是催眠镇痛可减轻肌电图检查(EMG)期间的疼痛和焦虑。
我们在教学医院的门诊电诊断诊所进行了一项前瞻性随机对照临床试验。就在肌电图检查前,26名受试者被随机分配到三个20分钟的音频程序之一:关于肌电图检查的教育(EDU)(n = 8);无镇痛暗示的催眠诱导(n = 10);或有镇痛暗示的催眠诱导(n = 8)。不知情的肌电图检查人员在肌电图检查开始时给予催眠后暗示。肌电图检查后,受试者使用视觉模拟量表对最严重疼痛、平均疼痛和焦虑进行评分。
EDU组、无镇痛暗示的催眠诱导组和有镇痛暗示的催眠诱导组的平均值无显著差异(平均值±标准差):最严重疼痛分别为67±25、42±18和49±30;平均疼痛分别为35±26、27±14和25±22;焦虑分别为44±41、42±23和22±24。当将催眠组合并(n = 18)并与EDU组(n = 8)进行比较时,催眠组的平均和最严重疼痛及焦虑低于EDU组,但仅最严重疼痛差异有统计学意义(催眠组,46±24 vs. EDU组,67±35;P = 0.049),平均减轻31%。
短暂的催眠诱导似乎可减轻肌电图检查期间的最严重疼痛。