Introduction Patients undergoing minimally invasive procedures under a light conscious sedation perceive pain and anxiety. Hypnosis used together with analgesics has been investigated in numerous studies. Aims and methods To assess the effectiveness of hypnotic analgesia in management of pain, anxiety, analgesic consumption, procedure length and adverse events in adults undergoing minimally invasive procedures. Clinical controlled trials in which hypnosis was used together with pharmacological analgesia compared to pharmacological analgesia alone during invasive procedures were included. Seven databases were searched. The methodological quality of the studies was assessed by two reviewers using a standardised instrument for critical appraisal from Joanna Briggs Institute, ‘Meta‐Analysis of statistics assessment and review Instrument’. Meta‐analyses using the review manager version 5.3 software were conducted on procedure length and adverse events. Results for pain, anxiety and analgesics were synthesised in narrative summaries. Conduction of the review adheres to the PRISMA checklist. Results Ten studies comprising 1,365 participants were included. A reduction in the consumption of pain medication was found between 21%–86% without aggravating pain intensity and anxiety. In few studies, significant reduction in pain intensity and anxiety was found. Meta‐analysis including seven studies revealed a small beneficial effect on reducing procedure length. A meta‐analysis on adverse events showed no significant reduction. Statistical heterogeneity was found among the studies included. Conclusion For patients undergoing invasive procedures, hypnotic analgesia was effective in reducing consumption of analgesics. Only a slight effect was, however, found on experienced anxiety and pain intensity. It did not prolong the procedure and was safe to provide. Relevance to clinical practice Hypnosis is recommended as pain management for adults during invasive procedures. A reduced consumption of pain medication potentially has a major impact on monitoring and observation of patients following the procedure, thus improving patient safety and reducing resource consumption.
Objective:The objective of this scoping review is to identify and map existing preoperative interventions, referred to as prehabilitation, in adult patients at home awaiting coronary bypass grafting (CABG) surgery. This scoping review also seeks to examine the feasibility and patient experiences in order to inform clinical practice and underpin a future systematic review.Introduction:As patients age, comorbidities become more common. Strategies to improve postoperative outcomes and to accelerate recovery are required in patients undergoing CABG. Prehabilitation refers to a proactive process of increasing functional capacity before surgery to improve the patient's capacity to withstand upcoming physiologic stress and thus avoid postoperative complications.Inclusion criteria:This scoping review will consider any studies including adult patients at home awaiting CABG surgery. Studies will provide information on any prehabilitation intervention to optimize preoperative physical and psychological health status. Studies conducted in any setting will be included.Methods:The methodology will follow the JBI recommendations for scoping reviews. Any published or unpublished source of information will be considered. Studies published in English, German, Danish, Swedish, and Norwegian will be included, with no geographical or cultural limitations. Retrieved papers will be screened by two independent reviewers, and a standardized tool will be used to extract data from each included source. The results will be presented as a map of the data extracted in a tabular form together with a narrative summary to provide a description of the existing evidence.
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