CHICAGO - Performing self-hypnotic relaxation sessions at the operating table significantly reduces pain and anxiety in patients who are undergoing large-core breast biopsy with local anesthesia, researchers said Wednesday at the 2006 RSNA meeting.
In addition to helping the patients, hypnosis appears to reduce both procedure costs and time -- perhaps by reducing patient movement, allowing for an easier operation, they reported.
"Hypnosis may be an attractive option not only for breast biopsy but for other procedures as well," said Dr. Elvira Lang, an associate professor of radiology at Harvard Medical School in Boston. "Hypnosis can greatly help women cope with the stress of breast biopsy."
Lang and colleagues recruited 236 women who were undergoing large-core breast biopsy procedures for the study. They randomly assigned the women into three groups: 76 women received usual, standard care, which generally meant no special treatment in the operating room; 82 women were accompanied by a friend or relative trained to be empathetic; and 78 women had a calm, third party read a standard script (Pain, December 15, 2006, Vol. 126:1-3, pp. 155-164) that promoted self-hypnosis.
For postoperative pain, when compared to the patients who received standard care, pain was reduced significantly (p = 0.0024) in the patients who received empathetic care and those who received hypnosis (p = 0.0018). The difference between empathy and hypnosis was not significant.
For anxiety, however, patients who received standard care were significantly more anxious after the procedure (p < 0.001) when compared to baseline anxiety levels. Those who had an empathetic person nearby showed no changed from baseline anxiety levels. Those receiving hypnotherapy showed a significant (p < 0.001) decline in anxiety.
Seven adverse events occurred in the standard care group, 11 in the empathetic care group, and three in the hypnosis group, Lang said. Standard care biopsies averaged 46 minutes, biopsies in the empathetic care group averaged 43 minutes, and biopsies in the hypnosis group averaged 39 minutes.
The average cost for performing a large-core biopsy was $161 in the standard care patients and $163 in the empathetic care patients. The procedure cost an average of $152 for the hypnosis patients, and that cost was reduced to $137.50 if someone on the biopsy team could perform the task of doing the hypnosis.
Lang did not perform statistical analyses on the time and costs.
"Self-hypnotic relaxation offers women undergoing breast biopsy a drug-free choice for reducing pain and anxiety without adding procedure time, cost, or side effects," Lang concluded.
"Physicians are trained from their earliest days in the profession about the positive use of interaction with the patient. We don't use that often enough," said Dr. Michael Brant-Zawadzki, medical director of the Hoag Memorial Hospital Presbyterian in Newport Beach, CA, who moderated the RSNA press briefing. "I've heard of similar approaches for hypnotherapy."
By Edward Susman
AuntMinnie.com contributing writer
November 30, 2006
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