Muhammad Abid Azam, Aliza Z Weinrib, P Maxwell Slepian, Brittany N Rosenbloom, Anna Waisman, Hance Clarke, Joel Katz
{"title":"围手术期临床催眠对肿瘤手术患者心率变异性的影响：随机对照试验的次要结果。","authors":"Muhammad Abid Azam, Aliza Z Weinrib, P Maxwell Slepian, Brittany N Rosenbloom, Anna Waisman, Hance Clarke, Joel Katz","doi":"10.3389/fpain.2024.1354015","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU).</p><p><strong>Methods: </strong>After REB approval, trial registration and informed consent, 92 participants were randomized to receive CH (<i>n</i> = 45) or TAU (<i>n</i> = 47). CH participants received a CH session before surgery and during post-surgical in-hospital stay HRV was assessed during rest (5 min) and relaxation (10 min) before and 1-month after surgery. Pain intensity was obtained using a 0-10 numeric rating scale pre and post 1-week and 1-month post surgery.</p><p><strong>Results: </strong>One month after surgery, HRV was significantly higher in CH group (<i>n</i> = 29) during rest and relaxation (both <i>p</i> < 0.05, <i>d</i> = 0.73) than TAU group (<i>n</i> = 28). By contrast, rest and relaxation HRV decreased from pre- to 1-month post-surgery for the TAU (both <i>p</i> < 0.001, <i>d</i> > 0.48) but not the CH group. Pain intensity increased from pre-surgery to 1-week post-surgery (<i>p</i> < 0.001, <i>d</i> = 0.50), and decreased from 1-week to 1-month post-surgery (<i>p</i> = 0.005, <i>d</i> = 0.21) for all participants.</p><p><strong>Discussion: </strong>The results suggest that hypnosis prevents the deleterious effects of surgery on HRV by preserving pre-operative vagal activity. These findings underscore the potential of clinical hypnosis in mitigating the adverse effects of surgery on autonomic function and may have significant implications for enhancing post-surgical recovery and pain management strategies.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier (NCT03730350).</p>","PeriodicalId":73097,"journal":{"name":"Frontiers in pain research (Lausanne, Switzerland)","volume":"5 ","pages":"1354015"},"PeriodicalIF":2.5000,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10957530/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effects of perioperative clinical hypnosis on heart rate variability in patients undergoing oncologic surgery: secondary outcomes of a randomized controlled trial.\",\"authors\":\"Muhammad Abid Azam, Aliza Z Weinrib, P Maxwell Slepian, Brittany N Rosenbloom, Anna Waisman, Hance Clarke, Joel Katz\",\"doi\":\"10.3389/fpain.2024.1354015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU).</p><p><strong>Methods: </strong>After REB approval, trial registration and informed consent, 92 participants were randomized to receive CH (<i>n</i> = 45) or TAU (<i>n</i> = 47). CH participants received a CH session before surgery and during post-surgical in-hospital stay HRV was assessed during rest (5 min) and relaxation (10 min) before and 1-month after surgery. Pain intensity was obtained using a 0-10 numeric rating scale pre and post 1-week and 1-month post surgery.</p><p><strong>Results: </strong>One month after surgery, HRV was significantly higher in CH group (<i>n</i> = 29) during rest and relaxation (both <i>p</i> < 0.05, <i>d</i> = 0.73) than TAU group (<i>n</i> = 28). By contrast, rest and relaxation HRV decreased from pre- to 1-month post-surgery for the TAU (both <i>p</i> < 0.001, <i>d</i> > 0.48) but not the CH group. Pain intensity increased from pre-surgery to 1-week post-surgery (<i>p</i> < 0.001, <i>d</i> = 0.50), and decreased from 1-week to 1-month post-surgery (<i>p</i> = 0.005, <i>d</i> = 0.21) for all participants.</p><p><strong>Discussion: </strong>The results suggest that hypnosis prevents the deleterious effects of surgery on HRV by preserving pre-operative vagal activity. These findings underscore the potential of clinical hypnosis in mitigating the adverse effects of surgery on autonomic function and may have significant implications for enhancing post-surgical recovery and pain management strategies.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier (NCT03730350).</p>\",\"PeriodicalId\":73097,\"journal\":{\"name\":\"Frontiers in pain research (Lausanne, Switzerland)\",\"volume\":\"5 \",\"pages\":\"1354015\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2024-03-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10957530/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in pain research (Lausanne, Switzerland)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fpain.2024.1354015\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in pain research (Lausanne, Switzerland)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fpain.2024.1354015","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
导言：临床催眠因其潜在的迷走神经介导的抗炎特性而被提议用于手术后疼痛治疗。要了解催眠对手术后恢复的有效性，还需要证据。在这项次要结果研究中，我们假设随机接受围手术期临床催眠（CH）的肿瘤外科患者在手术后 1 个月的评估中，与正常治疗组（TAU）相比，在休息和放松时会表现出更大的心率变异性（HRV）：在获得 REB 批准、试验注册和知情同意后，92 名参与者被随机分配到 CH 组（45 人）或 TAU 组（47 人）。CH组参与者在手术前接受一次CH治疗，并在手术后住院期间评估手术前和手术后1个月休息（5分钟）和放松（10分钟）时的心率变异。术前、术后 1 周和 1 个月的疼痛强度采用 0-10 数字评分量表进行评估：术后一个月，CH 组（29 人）在休息和放松时的心率变异（p d = 0.73）明显高于 TAU 组（28 人）。相比之下，从手术前到术后一个月，TAU 组的静息和放松心率变异均有所下降（p d 均 > 0.48），而 CH 组没有下降。所有参与者的疼痛强度从手术前增加到手术后一周（p d = 0.50），从手术后一周减少到手术后一个月（p = 0.005，d = 0.21）：讨论：研究结果表明，催眠可通过保留术前迷走神经活动来防止手术对心率变异的有害影响。这些发现强调了临床催眠在减轻手术对自主神经功能的不良影响方面的潜力，并可能对加强术后恢复和疼痛管理策略具有重要意义：临床试验注册：ClinicalTrials.gov，标识符（NCT03730350）。
Effects of perioperative clinical hypnosis on heart rate variability in patients undergoing oncologic surgery: secondary outcomes of a randomized controlled trial.
Introduction: Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU).
Methods: After REB approval, trial registration and informed consent, 92 participants were randomized to receive CH (n = 45) or TAU (n = 47). CH participants received a CH session before surgery and during post-surgical in-hospital stay HRV was assessed during rest (5 min) and relaxation (10 min) before and 1-month after surgery. Pain intensity was obtained using a 0-10 numeric rating scale pre and post 1-week and 1-month post surgery.
Results: One month after surgery, HRV was significantly higher in CH group (n = 29) during rest and relaxation (both p < 0.05, d = 0.73) than TAU group (n = 28). By contrast, rest and relaxation HRV decreased from pre- to 1-month post-surgery for the TAU (both p < 0.001, d > 0.48) but not the CH group. Pain intensity increased from pre-surgery to 1-week post-surgery (p < 0.001, d = 0.50), and decreased from 1-week to 1-month post-surgery (p = 0.005, d = 0.21) for all participants.
Discussion: The results suggest that hypnosis prevents the deleterious effects of surgery on HRV by preserving pre-operative vagal activity. These findings underscore the potential of clinical hypnosis in mitigating the adverse effects of surgery on autonomic function and may have significant implications for enhancing post-surgical recovery and pain management strategies.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
