Hypnosis as an alternative to general anaesthesia for paediatric superficial surgery: a randomised controlled trial.


Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
03 2023
Historique:
received: 02 08 2022
revised: 29 11 2022
accepted: 30 11 2022
pubmed: 24 1 2023
medline: 25 2 2023
entrez: 23 1 2023
Statut: ppublish

Résumé

Reducing perioperative anxiety and controlling pain in children are essential to optimise recovery and outcomes for both children and their parents. By acting on sensory and affective modulation of anxiety and pain, hypnosis is widely used in medical care, especially in anaesthesia. This randomised controlled clinical trial was designed to compare general anaesthesia and intraoperative hypnosis support for perioperative management of children undergoing superficial surgery. Children aged 7-16 yr scheduled for day-case superficial surgery were included and randomly assigned to one of the following two groups: general anaesthesia group or hypnosis group. The primary outcome was length of hospital stay. Child and parent anxiety, child pain, and the occurrence of postoperative negative behavioural changes were also evaluated. Sixty children of mean age 10.3 (standard deviation: 2.6) yr were enrolled in the study. Hypnosis was successful in all but one case. The median (25th-75th percentile) length of hospital stay was shorter in the hypnosis group (120 [95-145] vs 240.5 [218-275] min; P<0.001). The general anaesthesia group was associated with a greater incidence of high levels of preoperative anxiety in children (30 vs 11%; P=0.001) and parents (55 vs 30%; P=0.05). Pain scores did not differ between groups. No negative postoperative behavioural changes were reported. In children aged 7-16 yr, hypnosis appears to be feasible and accepted. The quality of the perioperative experience and the rapid recovery support the use of hypnosis as an effective and safe alternative to general anaesthesia for paediatric superficial surgery. NCT02505880.

Sections du résumé

BACKGROUND
Reducing perioperative anxiety and controlling pain in children are essential to optimise recovery and outcomes for both children and their parents. By acting on sensory and affective modulation of anxiety and pain, hypnosis is widely used in medical care, especially in anaesthesia. This randomised controlled clinical trial was designed to compare general anaesthesia and intraoperative hypnosis support for perioperative management of children undergoing superficial surgery.
METHODS
Children aged 7-16 yr scheduled for day-case superficial surgery were included and randomly assigned to one of the following two groups: general anaesthesia group or hypnosis group. The primary outcome was length of hospital stay. Child and parent anxiety, child pain, and the occurrence of postoperative negative behavioural changes were also evaluated.
RESULTS
Sixty children of mean age 10.3 (standard deviation: 2.6) yr were enrolled in the study. Hypnosis was successful in all but one case. The median (25th-75th percentile) length of hospital stay was shorter in the hypnosis group (120 [95-145] vs 240.5 [218-275] min; P<0.001). The general anaesthesia group was associated with a greater incidence of high levels of preoperative anxiety in children (30 vs 11%; P=0.001) and parents (55 vs 30%; P=0.05). Pain scores did not differ between groups. No negative postoperative behavioural changes were reported.
CONCLUSIONS
In children aged 7-16 yr, hypnosis appears to be feasible and accepted. The quality of the perioperative experience and the rapid recovery support the use of hypnosis as an effective and safe alternative to general anaesthesia for paediatric superficial surgery.
CLINICAL TRIAL REGISTRATION
NCT02505880.

Identifiants

pubmed: 36690538
pii: S0007-0912(22)00660-2
doi: 10.1016/j.bja.2022.11.023
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT02505880']

Types de publication

Randomized Controlled Trial Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

314-321

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Chrystelle Sola (C)

Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France. Electronic address: c-sola@chu-montpellier.fr.

Julie Devigne (J)

Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France.

Sophie Bringuier (S)

Department of Anaesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France.

Julien Pico (J)

Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.

Lucie Coruble (L)

Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France.

Xavier Capdevila (X)

Department of Anaesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France; Montpellier Neurosciences Institute, Montpellier University Hospital, Montpellier, France.

Guillaume Captier (G)

Department of Paediatric Plastic Surgery, Montpellier University Hospital, Montpellier, France.

Christophe Dadure (C)

Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.

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