Center for Children's Burns and Trauma Research, Level 7, Children's Health Research Center, The University of Queensland, South Brisbane, Queensland, Australia.
The Pegg Leditschke Children's Burns Center, Lady Cilento Children's Hospital, Level 5, South Brisbane, Queensland, Australia.
Pain. 2018 Sep;159(9):1790-1801. doi: 10.1097/j.pain.0000000000001276.
No randomized controlled trial has investigated the efficacy of hypnosis for reducing pain and improving wound-healing in children with burns. This randomized controlled trial aimed to investigate whether hypnosis decreases pain, anxiety, and stress and accelerates wound-healing in children undergoing burn wound procedures. Children (4-16 years) with acute burns presenting for their first dressing change were randomly assigned to a Hypnosis Group who received hypnosis plus standard care or a Standard Care Group who received standard pharmacological and nonpharmacological intervention. Repeated measures of pain intensity, anxiety, stress, and wound-healing were taken at dressing changes until ≥95% wound re-epithelialization. Data for 62 children were analyzed on an intent-to-treat basis using Generalized Estimating Equations (n = 35 Standard Care Group; n = 27 Hypnosis Group). An effect on the primary outcomes of pain and wound healing was not supported {self-reported pain intensity largest Mean Difference [MD] = -0.85 (95% confidence interval [CI]: -1.91 to 0.22), P = 0.12; MD for re-epithelialization = -0.46 [95% CI: -4.27 to 3.35], P = 0.81}. Some support was found for an effect on the secondary outcomes of preprocedural anxiety (MD = -0.80 [95% CI: -1.50 to -0.10], P = 0.03 before the second dressing change) and heart rate as a measure of stress (MD = -15.20 [-27.20 to -3.20], P = 0.01 and MD = -15.39 [-28.25 to -2.53], P = 0.02 before and after the third dressing change). Hypnosis may be effective for decreasing preprocedural anxiety and heart rate in children undergoing repeated pediatric wound care procedures but not for reducing pain intensity or accelerating wound healing.
尚无随机对照试验研究催眠术对减轻儿童烧伤疼痛和促进伤口愈合的疗效。本随机对照试验旨在研究催眠术是否能减轻疼痛、焦虑和压力，以及是否能加速儿童烧伤患者接受伤口处理时的伤口愈合。将首次换药时出现的急性烧伤的儿童（4-16 岁）随机分配至催眠组（接受催眠加标准护理）或标准护理组（接受标准药物和非药物干预）。在每次换药时测量疼痛强度、焦虑、压力和伤口愈合情况，直到≥95%的伤口重新上皮化。使用广义估计方程（n = 35 例标准护理组；n = 27 例催眠组）对 62 名儿童进行意向治疗分析。未支持催眠术对主要结局（疼痛和伤口愈合）有影响：{自我报告的疼痛强度最大平均差值[MD] = -0.85（95%置信区间[CI]：-1.91 至 0.22），P = 0.12；再上皮化的 MD = -0.46（95%CI：-4.27 至 3.35），P = 0.81}。对于次要结局，有一些支持催眠术有影响的证据，如预处理焦虑（MD = -0.80（95%CI：-1.50 至 -0.10），P = 0.03，在第二次换药前）和心率作为压力的衡量指标（MD = -15.20[-27.20 至 -3.20]，P = 0.01 和 MD = -15.39[-28.25 至 -2.53]，P = 0.02，在第三次换药前后）。催眠术可能对减轻儿童接受多次儿科伤口护理时的预处理焦虑和心率有效，但不能减轻疼痛强度或加速伤口愈合。
