Effects of perioperative clinical hypnosis on heart rate variability in patients undergoing oncologic surgery: secondary outcomes of a randomized controlled trial

• الحاوية / القاعدة: Frontiers in Pain Research
• المؤلفون الرئيسيون: Muhammad Abid Azam, Aliza Z. Weinrib, P. Maxwell Slepian, Brittany N. Rosenbloom, Anna Waisman, Hance Clarke, Joel Katz
• التنسيق: مقال
• اللغة: الإنجليزية
• منشور في: Frontiers Media S.A. 2024-03-01
• الموضوعات: clinical hypnosis; oncologic surgery; postoperative opioid use; postoperative pain; high frequency heart rate variability
• الوصول للمادة أونلاين: https://www.frontiersin.org/articles/10.3389/fpain.2024.1354015/full

IntroductionClinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU).MethodsAfter REB approval, trial registration and informed consent, 92 participants were randomized to receive CH (n = 45) or TAU (n = 47). CH participants received a CH session before surgery and during post-surgical in-hospital stay HRV was assessed during rest (5 min) and relaxation (10 min) before and 1-month after surgery. Pain intensity was obtained using a 0–10 numeric rating scale pre and post 1-week and 1-month post surgery.ResultsOne month after surgery, HRV was significantly higher in CH group (n = 29) during rest and relaxation (both p < 0.05, d = 0.73) than TAU group (n = 28). By contrast, rest and relaxation HRV decreased from pre- to 1-month post-surgery for the TAU (both p < 0.001, d > 0.48) but not the CH group. Pain intensity increased from pre-surgery to 1-week post-surgery (p < 0.001, d = 0.50), and decreased from 1-week to 1-month post-surgery (p = 0.005, d = 0.21) for all participants.DiscussionThe results suggest that hypnosis prevents the deleterious effects of surgery on HRV by preserving pre-operative vagal activity. These findings underscore the potential of clinical hypnosis in mitigating the adverse effects of surgery on autonomic function and may have significant implications for enhancing post-surgical recovery and pain management strategies.Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT03730350).