Hypnosis and progressive muscle relaxation for anxiolysis and pain control during extraction procedure in 8–12-year-old children: a randomized control trial

Abstract

Introduction Hypnosis (H) and Progressive Muscle Relaxation (PMR) have proven to be effective in a variety of medical settings; there is a paucity of their practical application in paediatric dentistry. The study aimed to comparatively evaluate the role of H and PMR on anxiety, heart rate (HR), oxygen saturation (SPO 2 ), blood pressure (BP), pain, and analgesic requirement during extraction in children. Materials and methods Sixty children aged 8–12 years undergoing primary molar extractions were randomly allocated to three groups—H, PMR, and control (C). The anxiety (proposed Visual Facial Anxiety scale), HR, and SPO 2 were measured pre/post-operatively with/without interventions (H, PMR, C) at 4 intervals. The BP and pain (Wong-Baker faces pain scale) were recorded pre- and post-operatively. Need for analgesic post-operatively was assessed. Results Statistically significant reduction in anxiety was noted post-extraction in H (0.30 ± 0.80), PMR (0.50 ± 0.69) ( p < 0.001*). HR showed a statistically significant drop after H, PMR application. ( p < 0.001*) No significant difference in SPO 2 was noted in the three groups ( p > 0.05). Pain control was well achieved using H (85%), PMR (70%); BP was well-regulated in the H, PMR compared to C group ( p < 0.001*). Need for analgesics was reduced in H (45%), PMR (50%) versus C (100%). Both techniques H, PMR were comparable in all measures. Conclusion Hypnosis and PMR are effective techniques for anxiolysis and pain control in paediatric dental patients.

A Sorrow Shared Is a Sorrow Halved? Patient and Parental Anxiety Associated with Venipuncture in Children before and after Liver Transplantation

“…The child could also be fully informed about the blood collection in advance, which would increase their sense of control and thus reduce anxiety during the blood collection [45,46]. Another starting point for reducing the anxiety of both parents and children would be relaxation techniques, which could be performed both before blood collection and during the procedure [47,48].…”

Clinical Hypnosis for Procedural Pain and Distress in Children: A Scoping Review

“…All studies were published in English between 1975 and 2022, with 39% published since 2010 (Figure 2. Number of included studies per decadeFigure 2) [45,[72][73][74][75][76][77][78][79][80][81][82][83][84][85]. Studies were conducted predominantly in America and Europe (Figure 3, Table 2).…”

“…2 Several studies (39%) did not report on factors influencing the pain and/or distress outcomes of 3 clinical hypnosis [73,74,[81][82][83][84][85][87][88][89]92,94,96,100,104,106]. Reported influencing factors included 4 intervention timing (e.g., during subsequent procedure), hypnotherapist's presence (e.g., hetero or 5 self-hypnosis), child baseline and procedural distress or anxiety, chemotherapy-induced emesis (i.e., 6 vomiting process), rapport with the hypnotherapist, and parents' distress-promoting behaviour 7 (Table 5) [45,72,77,78,91,93,98,99,105,107].…”

“…The correlation 15 between hypnotic suggestibility level and the pain and distress outcomes of clinical hypnosis was 16 reported to be strong in 7 studies [91][92][93][97][98][99]103] and weak in 3 studies [104,106,108] (Table 5). 17 The majority of studies (66%) did not assess hypnotic suggestibility nor the relationship with 18 outcomes [72][73][74][75][76][77][78][80][81][82][83][84][85][86][87]89,90,[94][95][96][100][101][102]105,107], whereas 8% of studies assessed hypnotic 19 suggestibility alone without assessing its relation to outcomes [45,79,88]. Hypnotic suggestibility 20 was mainly assessed using the Stanford Hypnotic Clinical Scale [45,79,91,92,[97][98]…”

“…Parents 11 were also requested to actively comfort children, refrain from over-reassurance, as well as briefly 21 including doctoral students [45,103,107]; anaesthetists [72,87,88]; dentists [75,79,89,90], and 22 nurses specialised in oncology-haematology, paediatric endoscopy, paediatrics, or anaesthesia 23 [76,77,81,82,96]. Clinical hypnosis was seldom provided by psychologists trained in hypnosis 24 (13%), including a psychologist experienced in the psychology of oncology and hypnosis [93], a 25 research psychologist experienced in hypnosis for pain [97], or a medical student certified in 26 psychiatry and trained by a psychiatrist [85]. Clinical hypnosis was also provided by specialists not There is also a great deal of heterogeneity in the 17 types of painful procedures examined in this review, with most of these procedures involving 18 paediatric oncology consistent with previous meta-analyses [52].…”