May 9, 2000

Adjunctive non-pharmacological analgesia for invasive medical procedures: a randomised trial

Lancet
Elvira V LangDavid Spiegel

Abstract

Non-pharmacological behavioural adjuncts have been suggested as efficient safe means in reducing discomfort and adverse effects during medical procedures. We tested this assumption for patients undergoing percutaneous vascular and renal procedures in a prospective, randomised, single-centre study. 241 patients were randomised to receive intraoperatively standard care (n=79), structured attention (n=80), or self-hypnotic relaxation (n=82). All had access to patient-controlled intravenous analgesia with fentanyl and midazolam. Patients rated their pain and anxiety on 0-10 scales before, every 15 min during and after the procedures. Pain increased linearly with procedure time in the standard group (slope 0.09 in pain score/15 min, p<0.0001), and the attention group (slope 0.04/15 min; p=0.0425), but remained flat in the hypnosis group. Anxiety decreased over time in all three groups with slopes of -0.04 (standard), -0.07 (attention), and -0.11 (hypnosis). Drug use in the standard group (1.9 units) was significantly higher than in the attention and hypnosis groups (0.8 and 0.9 units, respectively). One hypnosis patient became haemodynamically unstable compared with ten attention patients (p=0.0041), and 12 standard patients (p=0.00...Continue Reading

  • References17
  • Citations184

Mentioned in this Paper

Neuro-Oncological Ventral Antigen 2
Hemodynamic Instability
Nervousness
Invasive Medical Procedure, NOS
Visual Analog Pain Scale
Relaxation Techniques
Systolic Blood Pressure Measurement
Blood Vessel
Analgesics
Absence of Pain Sensation

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