Clinical Research Directory

Hypnosis During Mechanical Ventilation Weaning

Hypnosis is defined as an altered state of consciousness characterized by an increased susceptibility to suggestion. It is a technique commonly used in the medical field, primarily for the management of pain and anxiety. The literature demonstrates that better pain management is correlated with a shorter length of stay in the ICU and a shorter duration of mechanical ventilation. In patients hospitalized in the ICU requiring invasive mechanical ventilation, the emotional component plays a significant role in dyspnea, which can become an obstacle to weaning from ventilation. The analgesic and anxiolytic treatments used carry numerous side effects and contraindications, limiting their use in ICU patients. Furthermore, pulmonary edema is a common cause of failure to wean from invasive mechanical ventilation. By reducing the occurrence of hypertension and tachycardia, hypnosis could be used as a therapeutic strategy to limit its incidence. Thus, hypnosis could be a valuable therapeutic tool for improving tolerance and the success of ventilator weaning. Although hypnosis is already commonly used in intensive care units, its use is still limited by a lack of evidence for more specific indications. It is in this context that this study was conducted, to assess the feasibility of conducting a hypnosis session during weaning from invasive mechanical ventilation in the intensive care unit.

Effect of Clinical Hypnosis in Preoperative Anxiety Among Patients Undergoing an Abdominal Surgery.

This Multicenter randomized controlled trial evaluates clinical hypnosis efficacy for reducing perioperative anxiety and postoperative pain in abdominal surgery patients across 3 Moroccan centers (n=48-68). Intervention arm receives 15-20 min level 2 hypnosis session preoperatively; control receives standard psychological preparation. Primary outcome: VAS-anxiety post-intervention. Secondary: postoperative EVA-pain, analgesic consumption, length of stay. Study Design Prospective, multicenter, parallel-group RCT (1:1 allocation, stratified by center/sex). Inclusion: consenting ASA I-II adults for abdominal surgery. Primary endpoint powered for 10mm EVA reduction (80% power, α=0.05). Registration supports PhD thesis at ISSS/Université Hassan 1er Settat.

Importance of the Type of Communication Used During Paraapical Anesthesia in Dentistry

Can we improve our communication to provide better care for our patients? In the healthcare field, the patient's experience is closely linked to pain management. The dental profession often requires simple but invasive procedures, such as local anaesthetics for example, which are providers of discomfort and anxietý that cannot be ignored. Fear of the dentist or dental care is a widespread phenomenon in the general population, since dental anxiety is estimated to affect 36% of the population, and 12% are thought to suffer from extreme fear. Clinicians traditionally warn patients of pain before para-apical anesthesia. This is not surprising, since even today, during initial training for practitioners, patients are taught to be informed, or even warned, of the pain to come, for ethical reasons (i.e., not to lie to the patient) and "so that he/she can prepare for it" (what we will refer to in the remainder of this protocol as classic communication). In the same way as when the patient has acute or induced pain, as is the case here (pain induced by the anesthetic injection), the practitioner also learns to ask if the patient is in pain, and how much. However, the use of pain-related words or a focus on pain can lead to significant anxiety, which in turn lowers the pain threshold. Conversely, the use of positive communication is important, as it can improve the patient's perception of pain and subjective experience. There is a body of literature on the impact of hypnotic communication on pain during painful treatment, but in fields other than dentistry (e.g. venous voice placement - Fusco 2020). To our knowledge, there is no scientific basis on the impact of the type of communication on patient pain in the field of dentistry. If, as we assume, we do indeed find similar results in other fields of medicine, this basis could serve as a basis for modifying the teaching and hence the practice of our young practitioners. We aim to compare the effects of two types of communication (hypnotic and conventional) on patients' pain, comfort and anxiety during para-apical anesthesia in dentistry. Anxiety and comfort were assessed prior to anesthesia on a numerical scale ranging from 0 (no anxiety or comfort) to 10 (greatest imaginable anxiety or comfort). This assessment of anxiety and comfort is asked again after anesthesia has been performed, as well as the pain experienced during anesthesia.

Pain Management With Virtual Reality Hypnosis

The latency phase corresponds to the first phase of the first stage of labour, during which the parturient feels regular, rhythmic uterine contractions that are often painful, with or without changes of the cervix. This phase lasts an average of 8 hours for primiparous women, compared with 5 hours for multiparous women, and can last up to twenty hours in total. Cervical ripening corresponds to the medical induction of regular, painful uterine contractions in order to obtain a favourable cervix for the induction of labour. Cervical ripening is carried out either medically (oral or local prostaglandins) or mechanically (double balloon dilatation) and accounts for 69.2% of labour inductions, which in turn account for 25.8% of births. At Amiens-Picardie University Hospital, this maturation stage can last from a few hours to 2 days, depending on the service protocol. What these two stages of childbirth have in common is that they are both painful, with very few analgesic drugs available that can be used without side-effects on the foetus during pregnancy. In recent years, there has also been a growing demand from parturients for the use of non-medicinal therapies. It therefore seems essential to provide parturients with as many effective non-drug methods as possible to manage their pain properly. If virtual reality hypnosis sessions prove to be effective, they will provide better pain management for women in labour, reduce the use of morphine derivatives (with their attendant side-effects, particularly on the foetus), and above all meet the growing demand from women in labour for the most physiological possible support during childbirth.

Audio Hypnosis for Reducing Anxiety in Children and Adolescents Undergoing MRI: A Randomized Controlled Trial

The goal of this clinical trial is to find out if listening to an audio hypnosis recording can help reduce anxiety in children and adolescents (ages 6-14) who are getting an MRI scan without sedation. The main questions the study will answer are: Does listening to a hypnosis audio before an MRI help children feel less anxious? Can hypnosis audio help reduce scan interruptions or early terminations? To find out, researchers will compare one group of children who listen to the hypnosis audio with another group who receive the usual explanation from medical staff to see if the audio helps lower anxiety and makes the MRI process smoother. What participants will do: Be randomly placed into either the hypnosis group (who get access to the hypnosis audio) or the control group (who receive the usual explanation). Listen to the hypnosis audio as many times as they like before the MRI (if in the hypnosis group). Fill out questionnaires before and after the MRI to measure anxiety (both children and parents). Have their MRI scan while researchers track any interruptions or early terminations. Have their anxiety levels rated by MRI technologists after the scan. This study aims to see if a simple, non-medication method like audio hypnosis can help children feel calmer during MRI exams.

Impact of Hypnosis for Performing Lumbar Infusion Tests

Infusion tests are now the gold standard for the diagnosis of chronic adult hydrocephalus (CAH), also known as normal pressure hydrocephalus. It is an invasive procedure using the same approach as a lumbar puncture. Once the intrathecal puncture is performed, the intracranial pressure is measured in lateral decubitus via a pressure head. Dynamic tests (injection of 0.9% NaCl at a constant flow rate) are performed after recording the basal pressure. This type of test lasts 30 to 45 minutes in lateral decubitus. Patients with CAH have cognitive-behavioral disorders that can alter the gesture and its interpretation in case of movements or contractures. Movement artefacts lead to a longer recording time. The longer the test, the more the patients' tolerance tends to decrease. Moreover, the patient's feeling towards this test is important because it may have to be repeated. Pain, anxiety and patient comfort are essential parameters to consider. Non-medicinal techniques (hypnosis, music therapy) have shown a tendency to reduce anxiety in pediatric and adult populations with an impact on instantaneous anxiety but also on personality-related anxiety. Most studies are focused on specific pathologies, primarily in palliative care, or on pediatric application. The use of these techniques in an elderly population with mild cognitive-behavioral disorders has not been explored. The objective is to evaluate the impact of hypnosis on anxiety, pain and comfort during the lumbar infusion test.

Procedural Pain Management by Multimodal Sedation Analgesia Combining Hypnosis in Children With Congenital Heart Disease

The aim of this prospective randomized controlled trial is to evaluate therapeutic hypnosis as a co-analgesia in thoracic drain removal in children with congenital heart disease. The hypothesis of this study is that therapeutic hypnosis combined with a minimal effective dose of medicated and inhaled sedation-analgesia is not inferior to higher doses of sedation-analgesia usually employed. This would make possible the reduction of cumulative dose of sedative medication and their side effects.