L'Ateneo Parmense. Acta Bio-Medica: Organo Della Società Di Medicina E Scienze Naturali Di Parma
We wish to point out the outstanding importance of kidney biopsy in diagnosis of kidney diseases and enphasize the fact that it is very important for the patient to give one's full cooperation, in order to achieve the most successful results. Anxious subjects and children usually do not give this cooperation owing to their excessive emotional reactions to the special situation of the biopsy and so we think it useful to induce beforehand a hypnotic state in them, hoping that this would make it possible to carry out the research with the usual transcutaneous technique.
Hypnosis was compared with nonhypnotic behavioral techniques for efficacy in reducing pain and anxiety in 27 children and adolescents during bone marrow aspiration and in 22 children and adolescents during lumbar puncture. The patients and independent observers each rated (scale of 1 to 5) pain and anxiety during one to three procedures prior to intervention and one to three procedures with intervention. Prior to intervention for both groups, pain during bone marrow aspiration was rated as more severe (P less than 0.01) than pain during lumbar puncture.
Pediatric oncology patients undergo medical treatments which often require repeated lumbar punctures and bone marrow aspirations, in general a painful and anxiety-provoking experience. We offered a few patients the opportunity to volunteer for hypnotic help in pain control. The technique of the hypnosis put in practice is described extensively. With some adaptations it can be used for various diagnostical and/or therapeutical medical examinations that are painful for the child and/or anxiety-provoking.
This study provided a differential comparison of the efficacy of standardized instruction in hypnosis or active cognitive strategy for provision of relief from procedurally induced pain and anxiety. Subjects were instructed to self-direct in the use of strategies during medical procedures. Twenty pediatric oncology patients participated in the study. They were not informed that hypnosis was one of the strategies. Subjects were screened for hypnotizability and randomly assigned to treatments. Demographic data were collected.
Two patients underwent outpatient percutaneous liver biopsy under hypnosis without complications. One patient had severe anxiety about the procedure because of a previous adverse experience with liver biopsy and the other had a history of severe allergy to local anesthesia. Both patients had undergone a session of hypnosis at least once prior to the biopsy. One received no local anesthetic and the other received 1% lidocaine as a local anesthetic. Both patients were completely cooperative during the procedure with the required respiratory maneuvers.
Children with cancer often have difficulty coping with the invasive medical procedures that are part of diagnosis and treatment. Bone marrow aspirations and lumbar punctures are painful and cause some children severe anxiety and distress. The increased risk and expense of general anesthesia and the relative ineffectiveness of sedatives and anxiolytics has prompted clinicians to examine nonpharmacologic methods for controlling pain and distress.
Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. Two hundred and thirty-six women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n=82), or self-hypnotic relaxation (n=78) during their procedures.
OBJECTIVES: We aimed to quantify children's levels of pain and fear during needle puncture procedures in a context where intravenous sedation-analgesia seems to be effective for pain and anxiety relief. The relevance of a nonpharmacological intervention in the pharmacological regimen was evaluated. DESIGN: Fear and pain were assessed by children, parents and physicians, on a visual analog scale (VAS, 0-10 cm), before and during puncture procedures. Higher scores represented more intense pain/fear.
BACKGROUND AND OBJECTIVES: Ultrasound-guided transrectal prostate biopsy is a reference in the diagnosis of prostate neoplasias. The higher the number of samples, the greater is the pain and discomfort. The objective of this study was to compare three anesthetic techniques in this group of patients. METHODS: Forty-five patients were included in this study. Patients were divided into three groups: 1 - Propofol; 2 - Propofol + Prostatic Plexus Block; 3 - Propofol + Fentanyl.