Hypnosis for pain in pediatric oncology: relevant and effective or an intervention of the past?

Heidelberg, R. Elyse; Alschuler, Kevin N.; Ramsey, William A.; Alberts, Nicole M.

doi:10.1097/j.pain.0000000000001790

Cited by 4 publications

(3 citation statements)

References 64 publications

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“…Hypnosis is defined as “a state of consciousness involving focused attention and reduced awareness characterized by an enhanced capacity for response to suggestion.” 13 Hypnosis is effectiveness in pediatric perioperative pain and overall pain care (e.g., oncology, headage, and irritable bowel) 10,14,15 as an adjuvant to standard care. A few studies have also shown its effectiveness as an alternative to premedication with midazolam 16 or to general anesthesia for surgery in association with local anesthesia, 17 for transesophageal ultrasound or radiotherapy sessions.…”

Section: Discussionmentioning

confidence: 99%

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Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine

Polomeni,

Huguet,

Mariotti

et al. 2024

Pediatric Anesthesia

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IntroductionPain related to injection of propofol during induction of anesthesia decreases from 66.8% without prevention, to 22–31% of cases when lidocaine is associated. Hypnoanalgesia of the hand is currently used for painful procedures in children but has never been evaluated in this indication. The primary aim of this prospective randomized single‐blind study was to evaluate the efficacy of hypnoanalgesia of the hand for the prevention of moderate to severe pain during intravenous injection of propofol alone in comparison to lidocaine admixture. The secondary aim was to compare the global satisfaction of children in both methods.Patients and MethodsOne hundred patients aged 7–14 years, ASA 1‐2, admitted for scheduled surgery under general anesthesia were randomized into two groups. Group L received a mixture of 1% propofol (3 mg/kg) and 1% Lidocaine (0.3 mg/kg). Group H received 1% propofol (3 mg/kg) after hypnoanalgesia of the hand realized by a single experimented operator. A video was made in order to evaluate the pain related to propofol injection by a blinded observer using the 4‐point score of Cameron (painful ≥ 2). The global satisfaction of children was evaluated in postanesthesia care unit and documented if visual analog score was <7/10.ResultsNinety‐six patients were analyzed. The rate of painful patients did not differ significantly between groups (8.5% in group H [n = 47] vs 6.1% in group L [n = 49], OR= 0.70; 95% CI [0.13–3.35], p = 0.65), nor did the rate of nonsatisfied patients (10.6 in group H vs. 12.2% in group L, OR = 0.85; 95% CI [0.19–3.65], p = 1).ConclusionsOur results suggest that hypnoanalgesia of the hand alone is effective to prevent the pain related to propofol injection in children. No significant difference was found in comparison with lidocaine admixture nor for pain or satisfaction.

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Section: Discussionmentioning

confidence: 99%

“…pediatric perioperative pain and overall pain care (e.g., oncology, headage, and irritable bowel) 10,14,15 as an adjuvant to standard care.…”

Section: Ta B L Ementioning

confidence: 99%

Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine

Polomeni,

Huguet,

Mariotti

et al. 2024

Pediatric Anesthesia

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“…The current results suggest that it will be important to monitor patients who experience pain to ensure that pain management interventions are implemented in a timely manner. Also, it will be important to emphasize evidence-based nonpharmacologic interventions for pain (eg, cognitive-behavioral therapy, relaxation, and hypnosis 24 ) given the potential impact of opioids on neurocognitive performance. For example, patients can complete brief monitoring or screening evaluations 22,51 of neurocognitive outcomes and pain scores at systematic time points; if there is concern from the screening evaluation, additional assessment or targeted interventions can be provided.…”

Section: Discussionmentioning

confidence: 99%

Neuropathic pain and neurocognitive functioning in children treated for acute lymphoblastic leukemia

Partanen

Alberts

Conklin

et al. 2021

Pain

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Children with acute lymphoblastic leukemia (ALL) often experience treatment-related neurocognitive deficits and significant pain. Pain may exacerbate these cognitive impairments. This study examined neuropathic pain and neurocognitive outcomes in survivors of childhood ALL treated with contemporary therapy on a clinical trial (NCT00137111). There were 345 survivors (45% female, M 5 6.9 years at diagnosis) who completed neurocognitive assessments including measures of sustained attention, learning and memory, and parent ratings of attention during at least one of 4 time points: on-therapy (Induction and Reinduction), end of therapy, and 2 years post-therapy. At-risk performance was defined as a score at least 1SD below the age-adjusted mean. Data on neuropathic pain (events, duration, and severity according NCI Common Toxicity Criteria) and pharmacologic pain management (opioids and gabapentin) were ascertained. Results showed that 135 survivors (39%) experienced neuropathic pain during treatment. Compared with those without pain, survivors with pain had greater memory impairments at end of therapy (California Verbal Learning Test [CVLT]-Total, 24% vs 12%, P 5 0.046). Within the pain group, survivors who experienced a greater number of pain events (CVLT-Total 5 20.88, P 5 0.023) and those who were treated with opioids (versus gabapentin) had poorer learning and memory performance (CVLT-Total 5 20.73, P 5 0.011; Short Delay 5 20.57, P 5 0.024; Long Delay 5 20.62, P 5 0.012; and Learning Slope 5 20.45, P 5 0.042) across time points. These are considered medium-to-large effects (SD 5 0.45-0.88). Neuropathic pain may be a risk factor for learning problems after therapy completion, and treatment for pain with opioids may also adversely affect neurocognitive performance. Therefore, patients who experience pain may require closer monitoring and additional intervention for neurocognitive impairment.

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Pain Management in Curative and Palliative Clinical Settings for Pediatric Cancer Patients

Morgan

Allen

2022

Pediatric Surgical Oncology

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Hypnosis for pain in pediatric oncology: relevant and effective or an intervention of the past?

Cited by 4 publications

References 64 publications

Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine

Avoiding pain during propofol injection in pediatric anesthesia: Hypnoanalgesia of the hand versus intravenous lidocaine

Neuropathic pain and neurocognitive functioning in children treated for acute lymphoblastic leukemia

Pain Management in Curative and Palliative Clinical Settings for Pediatric Cancer Patients

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