Source/Disclosures
Disclosures: Garcia reports he received consultant fees from Boston Scientific and St. Jude Medical. Please see the study for all other authors’ relevant financial disclosures.
August 17, 2020
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Hypnosis alleviates pain, reduces morphine use during ablation for atrial flutter

Source/Disclosures
Disclosures: Garcia reports he received consultant fees from Boston Scientific and St. Jude Medical. Please see the study for all other authors’ relevant financial disclosures.
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Hypnosis was superior to placebo to alleviate pain and reduce the consumption of morphine during atrial flutter ablation, researchers found in a prospective, randomized study.

“This is the first randomized trial assessing hypnosis during an electrophysiology procedure,” Rodrigue Garcia, MD, MSc, consultant cardiologist and electrophysiologist at Centre Hospitalier Universitaire Poitiers in France, told Healio. “In addition to relieving pain, hypnosis reduced morphine complications.”

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In the PAINLESS study published in JACC: Clinical Electrophysiology, researchers analyzed data from 113 patients (mean age, 70 years; 21% women) who underwent atrial flutter ablation from October 2018 to September 2019. Patients were assigned hypnosis (n = 56) or placebo (n = 57). Both groups received their assigned intervention in addition to the institution’s standard of care analgesia protocol.

Rodrigue Garcia

“Atrial flutter ablation is often very painful and requires important doses of opioids to alleviate the patients,” Garcia said in an interview. “Alternative techniques such as hypnosis are routinely used in our lab, but there was no scientific evidence of utility.” 

Patients assigned hypnosis participated in the session with headphones. The session began after surgical-site antisepsis and before administration of local anesthesia. Those assigned placebo also received headphones during the procedure, although they listened to nonhypnotic relaxation suggestions and white noise.

The primary endpoint was pain perception during the procedure, which the patient quantified 45 minutes after the end of the procedure with a visual analog scale.

Forty-five minutes after atrial flutter ablation, patients assigned hypnosis had a lower visual analog scale score compared with those assigned placebo (4 points vs. 5.5 points; P < .001). The hypnosis group also had lower pain perception during the entire procedure, which was inquired upon every 5 minutes (1.7 points vs. 3.6 points; P < .001).

Patients assigned hypnosis had a better external evaluation of sedation during atrial flutter ablation compared with those assigned placebo (8.3 points vs. 5.4 points; P < .001).

The hypnosis group also required fewer doses of morphine compared with the placebo group (1.3 mg vs. 3.6 mg; P < .001).

“[Hypnosis] can easily be implemented during electrophysiology procedures,” Garcia told Healio. 

For more information:

Rodrigue Garcia, MD, MSc, can be reached at rodrigue.garcia@chu-poitiers.fr; Twitter: @rodriguegarcia4.