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Adjunctive Self-hypnotic Relaxation for Outpatient Medical Procedures: A Prospective Randomized Trial with Women Undergoing Large Core Breast Biopsy

机译：门诊医疗程序的辅助性自我催眠放松：正在进行大型核心乳房活检的女性的前瞻性随机试验。

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Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. 236 women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0–10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women’s anxiety increased significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = −0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = −0.27, p < 0.001). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management.
机译：门诊环境中的医疗程序在药理上难以控制疼痛和焦虑。因此，我们评估了这是否可以通过在常见且特别是引起焦虑的程序中进行辅助的自我催眠放松来实现。前瞻性将236名因接受大芯针穿刺活检而送往城市大学附属大学医学中心的妇女随机分组，以接受标准护理（n = 76），结构化的移情关注（n = 82）或自我催眠放松（n = 78）在他们的程序中。在序数逻辑回归模型中比较了患者在10分钟的疼痛和焦虑间隔下的自我评价（使用0–10个口头模拟量表），其中0 =完全没有疼痛/焦虑，10 =可能的最严重疼痛/焦虑。在标准组中，女性的焦虑显着增加（logit斜率= 0.18，p <0.001），在同情组中女性焦虑没有变化（斜率= -0.04，p = 0.45），而在催眠组中则明显降低（斜率= -0.27， p <0.001）。三组患者的疼痛显着增加（logit斜率：标准护理= 0.53，同情= 0.37，催眠= 0.34；所有p <0.001），尽管催眠和同情比标准护理陡峭（分别为p = 0.024和p = 0.018）。尽管催眠和换位需要额外的专业人员，但在单因素方差分析中，房间时间和费用没有显着差异：标准护理为46分钟/ 161美元，换位思考为43分钟/ 163美元，催眠为39分钟/ 152美元。我们得出的结论是，虽然结构化的移情和催眠都可以减轻程序性疼痛和焦虑，但是催眠提供了更强大的焦虑缓解功能，而又不会产生不必要的成本，因此对于门诊患者的疼痛管理似乎很有吸引力。

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