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白内障手术中用于疼痛感知管理的催眠干预。

Hypnosis intervention for the management of pain perception during cataract surgery.

作者信息

Chen Xiaofan, Yuan Rongdi, Chen Xiao, Sun Min, Lin Sen, Ye Jian, Chen Chunlin

机构信息

Department of Ophthalmology, Xinqiao Hospital, Third Military Medical University, Chongqing, 400042, China.

Department of Ophthalmology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China,

出版信息

J Pain Res. 2018 Sep 20;11:1921-1926. doi: 10.2147/JPR.S174490. eCollection 2018.

DOI:10.2147/JPR.S174490
PMID:30288086
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6160280/
Abstract

OBJECTIVE

To investigate the effectiveness of hypnosis in pain management during cataract surgery.

METHODS

Male or female patients with bilateral age-related cataract who wished to have both eyes subjected to phacoemulsification surgery were preliminarily admitted. Immediately after the first-eye surgery, each patient was evaluated for pain using the visual analog scale (VAS), and patients with a VAS score >1 were enrolled. By using block randomization, the enrolled patients were allocated to either the treatment group, which received a hypnosis intervention before the scheduled second-eye surgery, or the control group, which did not undergo hypnosis. The levels of anxiety, pain, and cooperation were evaluated independently by the patients and the surgeon.

RESULTS

During the intraoperative pain assessment, 5%, 34%, 38%, and 23% of patients in the control group reported experiencing no pain, mild pain, moderate pain, and severe pain, respectively. In contrast, in the hypnosis group, 18%, 56%, 15%, and 11% of patients reported experiencing no pain, mild pain, moderate pain, and severe pain, respectively, which showed significant differences between the groups (<0.005). The evaluation of anxiety level showed that the mean score in the control group and hypnosis group was 11.77±0.32 and 6.64±0.21, respectively, revealing a highly significant difference between the two groups (<0.005). The assessment of patient cooperation showed that only 5% and 18% of patients in the control group and 18% and 36% of patients in the hypnosis group showed excellent and good cooperation, respectively, while 47% of patients in the control group and only 24% of patients in the hypnosis group exhibited poor cooperation, revealing significant differences between the groups (<0.005).

CONCLUSION

Hypnosis may be considered as an auxiliary measure in cataract surgery, especially for patients who experienced obvious pain during the first-eye surgery.

摘要

目的

探讨催眠在白内障手术疼痛管理中的有效性。

方法

初步纳入希望双眼接受超声乳化手术的双侧年龄相关性白内障男性或女性患者。第一眼手术后立即使用视觉模拟量表(VAS)对每位患者的疼痛进行评估,VAS评分>1分的患者被纳入研究。采用区组随机化方法,将纳入的患者分配至治疗组(在预定的第二眼手术前接受催眠干预)或对照组(未接受催眠)。患者和外科医生分别独立评估焦虑、疼痛和合作程度。

结果

在术中疼痛评估中,对照组分别有5%、34%、38%和23%的患者报告无疼痛、轻度疼痛、中度疼痛和重度疼痛。相比之下,催眠组分别有18%、56%、15%和11%的患者报告无疼痛、轻度疼痛、中度疼痛和重度疼痛,两组间差异有统计学意义(<0.005)。焦虑水平评估显示,对照组和催眠组的平均评分分别为11.77±0.32和6.64±0.21,两组间差异有高度统计学意义(<0.005)。患者合作情况评估显示,对照组分别仅有5%和18%的患者表现为优秀和良好合作,催眠组分别有18%和36%的患者表现为优秀和良好合作,而对照组47%的患者和催眠组仅24%的患者表现为合作不佳,两组间差异有统计学意义(<0.005)。

结论

催眠可被视为白内障手术中的一种辅助措施,尤其适用于第一眼手术时经历明显疼痛的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/0eefd460dced/jpr-11-1921Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/784366e659a5/jpr-11-1921Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/10b71036627b/jpr-11-1921Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/d94346822ce1/jpr-11-1921Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/4a348742e92f/jpr-11-1921Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/0eefd460dced/jpr-11-1921Fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/784366e659a5/jpr-11-1921Fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/10b71036627b/jpr-11-1921Fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/d94346822ce1/jpr-11-1921Fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/4a348742e92f/jpr-11-1921Fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1a4e/6160280/0eefd460dced/jpr-11-1921Fig5.jpg

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