Bataille Aurélien, Besset Sébastien, Szekely Barbara, Michel-Cherqui Mireille, Dumans Virginie, Liu Ngai, Chazot Thierry, Fischler Marc, Le Guen Morgan
Department of Anesthesia, Burn and Critical Care, University Hospitals Saint Louis Lariboisière, Paris, France and University Paris Diderot, Paris Department of Anesthesia, Foch Hospital, Suresnes, France and University Versailles Saint-Quentin en Yvelines, France.
Medicine (Baltimore). 2017 May;96(19):e6389. doi: 10.1097/MD.0000000000006389.
The automated administration of propofol in a closed loop could be used to objectively evaluate the nonpharmacological anesthetic action of hypnotherapy. The objective of this study was to evaluate the impact of a conversational hypnosis session on the consumption of propofol for anesthetic induction.
A randomized, usual care-controlled, single-center, patient-blind trial.
Tertiary care center in France from November 2012 to December 2013.
Adult patients scheduled for a surgical procedure under general anesthesia.
Before surgery, patients were randomized with a computer-generated random list for a preoperative conversational hypnosis session or for usual care. The conversational hypnosis session was conducted and individualized by the therapist with an academic degree in hypnosis in a quiet environment. Anesthetic induction was automatically performed by propofol without opioids and was assisted by the bispectral index in a closed loop.
Primary endpoint was the propofol dose required for anesthesia induction, defined as a Bispectral index less than 60 for at least 30 seconds.
The study included 48 patients in the hypnosis group and 49 patients in the control group. No difference in propofol consumption to obtain anesthesia induction was observed between the groups (total dose: 138.6 [67.5] and 130 [47.9] mg, P = .47; adjusted dose: 2.15 [1.09] and 1.95 [0.66] mg/kg, P = .28, for the hypnosis and control groups, respectively). Hetero-evaluation of arm movement during propofol injection (no reaction: 98% and 74%; P = .004, in the hypnosis and control groups, respectively) and face reaction at venous access placement (no reaction 59% and 30%; P = .017, in the hypnosis and control groups, respectively) were lower in the hypnosis group. No adverse event was reported.
No difference in propofol consumption was observed in this study designed to evaluate the effect of a hypnotic conversational session on anesthesia induction using an automated tool for propofol administration.
丙泊酚闭环自动给药可用于客观评估催眠疗法的非药理学麻醉作用。本研究的目的是评估一次对话式催眠对麻醉诱导丙泊酚用量的影响。
一项随机、常规护理对照、单中心、患者盲法试验。
2012年11月至2013年12月法国的三级护理中心。
计划接受全身麻醉手术的成年患者。
手术前，通过计算机生成的随机列表将患者随机分为术前接受对话式催眠或接受常规护理。对话式催眠由具有催眠学学位的治疗师在安静环境中进行并个体化实施。麻醉诱导由丙泊酚自动完成，不使用阿片类药物，并在闭环中由脑电双频指数辅助。
主要终点是麻醉诱导所需的丙泊酚剂量，定义为脑电双频指数低于60至少30秒。
研究纳入催眠组48例患者和对照组49例患者。两组之间在获得麻醉诱导的丙泊酚用量上未观察到差异（催眠组和对照组的总剂量分别为138.6[67.5]和130[47.9]mg，P = 0.47；调整剂量分别为2.15[1.09]和1.95[0.66]mg/kg，P = 0.28）。在丙泊酚注射期间手臂运动的他人评估（无反应：催眠组和对照组分别为98%和74%；P = 0.004）以及静脉穿刺时面部反应（无反应：催眠组和对照组分别为59%和30%；P = 0.017）在催眠组中较低。未报告不良事件。
在本旨在评估催眠对话对使用丙泊酚自动给药工具进行麻醉诱导效果的研究中，未观察到丙泊酚用量的差异。
