Hypnosis for Acute Procedural Pain:A Critical Review

Abstract

Clinical evidence for the effectiveness of hypnosis in the treatment of acute, procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions.

The effectiveness of hypnotic analgesia in the management of procedural pain in minimally invasive procedures: A systematic review and meta‐analysis

“…Therefore, meta‐analyses were not performed in the present systematic review. The differences described were also found in previous systematic reviews of hypnosis for pain relief in diagnostic or medical procedures (Cheseaux, De Saint Lager, & Walder, ; Kendrick et al, ).…”

“…A one‐dimensional instrument was used to measure pain intensity in the studies included in the present review, and it might therefore be difficult to observe an effect. This challenge was also described in a previous review (Kendrick et al, ) and points towards an important issue; that the outcomes of the interventions should be measured with tools that can capture the phenomena in question. Otherwise, an effective intervention could be rejected.…”

“…With the purpose of obtaining a more accurate estimate of the effect of hypnotic analgesia on pain and anxiety during invasive procedures, inclusion criteria with relation to the population and type of procedure or treatment were limited in this present systematic review compared to other recent reviews in the field (Cheseaux et al, ; Kendrick et al, ; Stoelb et al, ; Tefikow et al, ). We included adults, 18 years and older, who had undergone a minimally invasive procedure in a conscious sedation.…”

“…However, two recent systematic reviews (Kendrick et al, ; Tefikow et al, ) published in 2013 and 2016 with literature searches finished in 2011 and 2013, respectively, included only randomised controlled trials and covered a broader range of medical and surgical procedures such as open surgery and a few invasive procedures. They included studies with a mixture of children and adults in the review (Kendrick et al, ). These factors could influence the applicability with regard to procedural pain in adult patients undergoing minimally invasive procedures.…”

“…Hypnotic analgesia has been tested in many trials to reduce pain and anxiety during both medical and surgical procedures (Kendrick et al, 2016;Montgomery, David, Winkel, Silverstein, & Bovbjerg, 2002;Patterson & Jensen, 2003;Schnur, Kafer, Marcus, & Montgomery, 2008;Stoelb, Molton, Jensen, & Patterson, 2009;Tefikow et al, 2013). Invasive procedures in which hypnotic analgesia has been used together with usual pain medication with greater effectiveness compared to conventional care or usual pain medication include large core breast biopsy, percutaneous tumour treatment, radiological, percutaneous vascular, cardiovascular and renal procedures.…”