Intensive Care Clinic, Ankara City Hospital, Ankara, Turkey.
Intensive Care Clinic, İstanbul Başakşehir City Hospital, İstanbul, Turkey.
J Endourol. 2021 Jan;35(1):47-53. doi: 10.1089/end.2020.0101. Epub 2020 Sep 29.
Cystoscopy is one of the most common procedures in outpatient urology. Although flexible cystoscopes are more tolerable, rigid cystoscopes have still been used in many clinics because of their lower costs, better visual performance, and easier handling. It can be difficult to achieve optimal relief of pain and anxiety during rigid cystoscopy. The aim of the present prospective randomized study was to evaluate the efficacy of hypnosis as an adjunct to routine local anesthesia in reducing pain and anxiety in rigid cystoscopy patients. Ninety male patients undergoing rigid cystoscopy for the first time were randomized into two groups: (1) Hypnosis Group (Group H) patients underwent cystoscopy with hypnotic communication as an adjuvant approach for periprocedural analgesia and anxiety, (2) Standard Care Group (Group SC) patients underwent cystoscopy with routine local anesthesia and lubrication as control group. The data were collected using visual analog scale (VAS) for pain, State-Trait Anxiety Inventory (STAI) for anxiety and hemodynamic parameters. Furthermore, a VAS was also completed by the urologist to assess his satisfaction. Baseline characteristics, STAI, hemodynamic parameters, and recovery duration were statistically similar between the two groups. The procedure duration was shorter in Group H ( = 0.018). The postprocedural STAI and VAS scores of patients in Group H were significantly lower than those of Group SC ( = 0.006; = 0.02, respectively). Heart rate and mean arterial pressure after positioning of the patient ( = 0.000; = 0.004, respectively) and insertion of the cystoscope ( = 0.000; = 0.000) were statistically lower in Group H, whereas baseline, postprocedural, and predischarge hemodynamic measurements were similar. Urologists were also more satisfied in Group H ( = 0.000). Hypnosis as an adjunct therapy to local anesthesia during rigid cystoscopy significantly reduces pain and anxiety, provides more stable hemodynamic conditions, shortens procedure duration, and thus appears attractive for pain and anxiety management.
膀胱镜检查是门诊泌尿外科最常见的操作之一。尽管软性膀胱镜检查的耐受性更好，但由于其成本较低、视觉效果更好且操作更简单，硬性膀胱镜检查仍在许多诊所中使用。在硬性膀胱镜检查过程中，很难达到最佳的疼痛缓解和焦虑缓解效果。本前瞻性随机研究的目的是评估催眠作为常规局部麻醉的辅助手段，在减轻硬性膀胱镜检查患者疼痛和焦虑方面的疗效。90 名首次接受硬性膀胱镜检查的男性患者被随机分为两组：（1）催眠组（H 组）患者在接受膀胱镜检查时进行催眠沟通，作为围手术期镇痛和焦虑的辅助方法；（2）标准护理组（SC 组）患者在接受膀胱镜检查时进行常规局部麻醉和润滑，作为对照组。使用视觉模拟评分（VAS）评估疼痛、状态-特质焦虑量表（STAI）评估焦虑和血液动力学参数来收集数据。此外，泌尿科医生还使用 VAS 评估了他的满意度。两组患者的基线特征、STAI、血液动力学参数和恢复时间均无统计学差异。H 组的手术时间更短（=0.018）。H 组患者术后 STAI 和 VAS 评分明显低于 SC 组（=0.006；=0.02，分别）。患者定位后（=0.000；=0.004，分别）和插入膀胱镜时（=0.000；=0.000）的心率和平均动脉压也较低，而基线、术后和出院前的血液动力学测量结果相似。H 组的泌尿科医生也更满意（=0.000）。催眠作为硬性膀胱镜检查中局部麻醉的辅助治疗方法，可显著减轻疼痛和焦虑，提供更稳定的血液动力学条件，缩短手术时间，因此在疼痛和焦虑管理方面具有吸引力。
