Analgesic efficacy of clinical hypnosis in pediatric patients following orthopedic surgery

Introduction

Clinical hypnosis is effective for pain management in adults, but there is little evidence of its use in the pediatric population.

Materials and Methods

We conducted a randomized clinical trial on pediatric patients (aged 7–19 years) that had undergone major orthopedic surgery, allocated to one of two groups: the experimental hypnosis group (HG), which received two sessions of clinical hypnosis, or the control group (CG), which had two non-hypnosis visits. The variables analyzed were pain (Visual Analog Scale [VAS]), use of analgesic drugs, anxiety (State-Trait Anxiety Inventory for Children [STAIC]), parasympathetic activation (Analgesia Nociception Index [ANI] monitor) and vital signs such as heart rate (HR), respiratory rate (RR) and systolic and diastolic blood pressure (SBP and DBP). We used the Student t test and the χ² test for the statistical analysis.

Results

Of the 24 patients in the sample, 16 were assigned to the HG and 8 to the CG. In the HG, we observed a significant reduction in VAS scores at 24 h (P = .0001) and 48 h (P = .0004) post surgery. Additionally, HG patients required fewer rescue doses of analgesic agents (P = .025) and had lower state-anxiety scale scores in the STAIC (P = .046). The ANI values increased significantly at 24 h (P = .0001) and 48 h (P = .007). The HR, SBP and DBP values decreased at 24 h (P < .05), and the RR at 24 and 48 h (P < .05).

Conclusion

Clinical hypnosis is an effective nonpharmacological intervention for reducing postoperative pain and anxiety in children, and it is associated with an increase in parasympathetic tone.