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评估在小儿手术室进行短暂催眠对减少术后疼痛和焦虑的效果:一项随机研究。

Assessment of a short hypnosis in a paediatric operating room in reducing postoperative pain and anxiety: A randomised study.

机构信息

Pain Management Unit, Department of Anaesthesiology, AP-HP, Hôpital Robert-Debré, Paris, France.

Unit of Clinical Epidemiology and CIC-EC 1456, AP-HP, Hôpital Robert-Debré, Paris, France.

出版信息

J Clin Nurs. 2018 Jan;27(1-2):86-91. doi: 10.1111/jocn.13848. Epub 2017 Jul 4.

Abstract

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.

摘要

目的和目标

评估短程催眠对重大骨科手术后焦虑和疼痛的影响。

背景

尽管在计划进行小儿手术前提供了具体信息,但围手术期焦虑仍可能变得重要。

设计

随机临床研究。

方法

该研究是一项开放的单中心随机临床研究,比较了“对照组”和“催眠组”,后者在诱导前接受短程催眠作为额外的实验性镇痛程序。主要终点是使用视觉模拟量表盲法评估的术后焦虑。

结果

该研究涉及 120 名儿童(年龄 10-18 岁)。结果显示,对照组与催眠组之间无差异。手术后 24 小时(术后第 1 天),对照组和催眠组患者的焦虑评分无差异(中位数[Q1-Q3]:1[0;3]与 0[0;3],p=0.17)。两组在手术前一天(术前第 1 天)和手术后一天(术后第 1 天)之间的焦虑水平均显著下降(焦虑评分的中位数[Q1-Q3]差异:2[4;0]和 2[4;0],p<0.0001,每组)。术后疼痛评分较低且两组间无差异(对照组中位数[Q1-Q3]:2[0;3],催眠组中位数[Q1-Q3]:3[1;3],p=0.57)。

结论

这项在重大手术前手术室进行的短程催眠研究显示,术后焦虑和疼痛水平无差异。焦虑和疼痛水平的降低可能是由于术前护士访谈和手术室沟通优化的增加。

相关性至临床实践

由于对照组和催眠组的术后焦虑水平均较低,因此术前护士访谈和护士催眠培训可能有助于优化整体管理并降低术后焦虑水平。

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