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The Feasibility of Hypnotic Analgesia in Ameliorating Pain and Anxiety Among Adults Undergoing Needle Electromyography

Slack, David MD; Nelson, Lonnie PhD; Patterson, David PhD; Burns, Stephen MD; Hakimi, Kevin MD; Robinson, Lawrence MD

American Journal of Physical Medicine & Rehabilitation: January 2009 - Volume 88 - Issue 1 - p 21-29
doi: 10.1097/PHM.0b013e31818e00bd
Original Research Article: Electromyography

Slack D, Nelson L, Patterson D, Burns S, Hakimi K, Robinson L: The feasibility of hypnotic analgesia in ameliorating pain and anxiety among adults undergoing needle electromyography. Am J Phys Med Rehabil 2009;88:21–29.

Objective: Our hypothesis was that hypnotic analgesia reduces pain and anxiety during electromyography (EMG).

Design: We performed a prospective randomized, controlled clinical trial at outpatient electrodiagnostic clinics in teaching hospitals. Just before EMG, 26 subjects were randomized to one of three 20-min audio programs: education about EMG (EDU) (n = 8); hypnotic induction without analgesic suggestion (n = 10); or hypnotic induction with analgesic suggestion (n = 8). The blinded electromyographer provided a posthypnotic suggestion at the start of EMG. After EMG, subjects rated worst and average pain and anxiety using visual analog scales.

Results: Mean values for the EDU, hypnotic induction without analgesic suggestion, and hypnotic induction with analgesic suggestion groups were not significantly different (mean ± SD): worst pain 67 ± 25, 42 ± 18, and 49 ± 30; average pain 35 ± 26, 27 ± 14, and 25 ± 22; and anxiety 44 ± 41, 42 ± 23, and 22 ± 24. When hypnosis groups were merged (n = 18) and compared with the EDU condition (n = 8), average and worst pain and anxiety were less for the hypnosis group than EDU, but this was statistically significant only for worst pain (hypnosis, 46 ± 24 vs. EDU, 67 ± 35; P = 0.049) with a 31% average reduction.

Conclusions: A short hypnotic induction seems to reduce worst pain during electromyography.

From the Rehabilitation Care Services Electrodiagnostic Clinic, Veterans Affairs Puget Sound Health Care System (DS); and Department of Rehabilitation Medicine, University of Washington, School of Medicine, Harborview Medical Center Electrodiagnostic Clinic, Seattle, Washington (LN, DP, SB, KH, LR).

All correspondence and requests for reprints should be addressed to Lawrence R. Robinson, MD, University of Washington, Clinical Affairs, Box 356380, Seattle, WA 98195.

This study was supported in part by grant R01 GM42725-09A1 from the National Institutes of Health.

© 2009 Lippincott Williams & Wilkins, Inc.