Marc I, Rainville P, Verreault R, Vaillancourt L, Masse B, Dodin S.

Reduction of pain medication during first-trimester surgical abortion by a brief hypnotic intervention.

Chaire Lucie et André Chagnon pour l'avancement d'une approche intégrée en prévention, Université Laval, Quebec City, PQ Canada, Centre de recherche de l'Hôpital Saint-François d'Assise (CHUQ), 45 rue Leclerc, Local D6-702, Québec G1L 3L5, Canada. isabelle.marc@crsfa.ulaval.ca

OBJECTIVES: This report describes an open randomized study to determine whether a brief hypnotic intervention during first-trimester surgical abortion reduces requests for pain medication.

METHODS: 30 women undergoing first-trimester surgical abortion at the family planning clinics of a large hospital in Quebec City were randomized into a control group that received standard care and a hypnosis group that received, in addition to standard care, an intervention of hypnosis including analgesia suggestions 20 minutes before and throughout the surgical procedure. Patients in both groups were given the option to control their pain with nitrous oxide (N2O) sedation administered through a nose mask as often and for as long as they wanted during the procedure. N2O sedation as the primary outcome was assessed at each step of the procedure. The patient's self-reported anxiety and pain were also assessed during the procedure as secondary outcomes.

RESULTS: 36% of patients in the hypnosis group requested N2O sedation during the procedure versus 87% in the control group (p<0.01). No differences between the groups were found in reports of pain and anxiety during the procedure.

DISCUSSION: These preliminary results suggest that hypnosis can be integrated into standard care and reduces the need for N2O in patients undergoing first-trimester surgical abortion. This reduction in N2O consumption did not lead to significant changes in pain or anxiety and a larger sample size is required to assess possible effects of hypnosis on those variables. In a main study (under recruitment), the main outcome (success) is defined by the combination of 1) the superiority of hypnosis versus standard treatment with medication (intra-venous conscious sedation) during the intervention AND 2) the non-inferiority of hypnosis versus standard treatment with respect to anxiety, and the intensity of pain during abortion.

 

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