Department of Diagnostic and Interventional Radiology, Cardiothoracic and Vascular Unit, University Hospital, Rue du Bugnon 46, CH - 1011, Lausanne, Switzerland.
Faculty of Biology and Medicine (FBM), University of Lausanne (UNIL), Lausanne, Switzerland.
Cardiovasc Intervent Radiol. 2023 Jun;46(6):786-793. doi: 10.1007/s00270-023-03394-1. Epub 2023 Mar 21.
Hypnosis is useful for diminishing distress during medical procedures. This study investigated the efficacy of virtually augmented self-hypnosis as an adjunctive non-pharmacological method for procedural pain and anxiety relief during endovascular interventions (EVI).
We compared an immersive distraction experience (clinicaltrials.gov identifier NCT04561596) featuring virtual reality (VR) using a head-mounted display versus treatment as usual (TAU). Patients followed the "Aqua" module (Oncomfort™) consisting of a scuba dive and breathing exercises. They experienced a self-induced dissociative state similar to clinical hypnosis without direct intervention of a professional. Enrollment followed a 1:1 randomized open study (VR or TAU). Patients' feelings were evaluated just before and after the procedure, and 3 months following intervention. Anxiety was evaluated using the State Trait Anxiety Inventory (STAI) and pain (sensory, emotional, and memory) with a visual analogue scale (VAS).
This study included 100 patients. Mean anxiety (pre-post) was significantly reduced within groups and between groups (difference of 4.2 points, p = 0.016). The percentage of responders to anxiety lowering were 76 and 46% for VR and TAU, respectively (p = 0.004). The two groups did not significantly differ in mean sensory-intensity and affective emotional pain (pre-post) using VAS, in negative memories concerning remembered pain at 3 months (difference > 1 from immediate post-procedural reported pain intensity), mean procedural time, or the need for analgesic or sedative drugs.
VR self-hypnosis has the potential to improve the management of patients' distress during radiological procedures. It is safe and effective for reducing anxiety during EVI.
催眠在减轻医疗程序中的痛苦方面很有效。本研究调查了虚拟增强自我催眠作为一种辅助非药物方法，在血管内介入（EVI）过程中缓解疼痛和焦虑的效果。
我们比较了一种沉浸式分散注意力的体验（clinicaltrials.gov 标识符 NCT04561596），该体验使用虚拟现实（VR）头戴式显示器与常规治疗（TAU）。患者遵循“水”模块（Oncomfort™），包括潜水和呼吸练习。他们经历了一种类似于临床催眠的自我诱导的分离状态，而无需专业人员的直接干预。招募遵循 1:1 随机开放研究（VR 或 TAU）。患者在手术前和手术后以及干预后 3 个月评估他们的感受。使用状态特质焦虑量表（STAI）评估焦虑，使用视觉模拟量表（VAS）评估疼痛（感觉、情绪和记忆）。
本研究包括 100 名患者。组内和组间的平均焦虑（术前-术后）均显著降低（差异为 4.2 分，p=0.016）。VR 和 TAU 降低焦虑的应答者比例分别为 76%和 46%（p=0.004）。两组在 VAS 上的平均感觉强度和情感疼痛（术前-术后）、3 个月时关于记忆疼痛的负面记忆（差异大于即时术后报告疼痛强度）、平均手术时间或对镇痛或镇静药物的需求方面没有显著差异。
VR 自我催眠有可能改善放射程序中患者痛苦的管理。它是安全有效的，可用于减轻 EVI 期间的焦虑。
