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Efficacy of hypnosis on pain, wound-healing, anxiety, and stress in children with acute burn injuries

a randomized controlled trial

Chester, Stephen J.a,b,c,d; Tyack, Zephaniea,b,*; De Young, Alexandraa,b; Kipping, Belindaa,b; Griffin, Bronwyna,b; Stockton, Kelliea,b; Ware, Robert S.e,f; Zhang, Xig; Kimble, Roy M.a,b,c

doi: 10.1097/j.pain.0000000000001276
Research Paper
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No randomized controlled trial has investigated the efficacy of hypnosis for reducing pain and improving wound-healing in children with burns. This randomized controlled trial aimed to investigate whether hypnosis decreases pain, anxiety, and stress and accelerates wound-healing in children undergoing burn wound procedures. Children (4-16 years) with acute burns presenting for their first dressing change were randomly assigned to a Hypnosis Group who received hypnosis plus standard care or a Standard Care Group who received standard pharmacological and nonpharmacological intervention. Repeated measures of pain intensity, anxiety, stress, and wound-healing were taken at dressing changes until ≥95% wound re-epithelialization. Data for 62 children were analyzed on an intent-to-treat basis using Generalized Estimating Equations (n = 35 Standard Care Group; n = 27 Hypnosis Group). An effect on the primary outcomes of pain and wound healing was not supported {self-reported pain intensity largest Mean Difference [MD] = −0.85 (95% confidence interval [CI]: −1.91 to 0.22), P = 0.12; MD for re-epithelialization = −0.46 [95% CI: −4.27 to 3.35], P = 0.81}. Some support was found for an effect on the secondary outcomes of preprocedural anxiety (MD = −0.80 [95% CI: −1.50 to −0.10], P = 0.03 before the second dressing change) and heart rate as a measure of stress (MD = −15.20 [−27.20 to −3.20], P = 0.01 and MD = −15.39 [−28.25 to −2.53], P = 0.02 before and after the third dressing change). Hypnosis may be effective for decreasing preprocedural anxiety and heart rate in children undergoing repeated pediatric wound care procedures but not for reducing pain intensity or accelerating wound healing.

A randomized controlled trial demonstrated that hypnosis was not effective for reducing pain and improving re-epithelialization in children. Some support was found for decreasing preprocedural anxiety and heart rate in children undergoing wound care procedures.

aCenter for Children's Burns and Trauma Research, Level 7, Children's Health Research Center, The University of Queensland, South Brisbane, Queensland, Australia

bThe Pegg Leditschke Children's Burns Center, Lady Cilento Children's Hospital, Level 5, South Brisbane, Queensland, Australia

cFaculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia

dOchsner Clinical School, Ochsner Clinic Foundation, New Orleans, LA, United States

eMenzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia

fUQ Child Health Research Center, The University of Queensland, South Brisbane, Queensland, Australia

gInstitute of Health and Biomedical Innovation, School of Biomedical Science, Queensland University of Technology, Brisbane, Queensland, Australia

Corresponding author. Address: Children's Health Research Center, 62 Graham St, South Brisbane, Queensland 4101, Australia. Tel.: (+61) 04 2746 2286. E-mail address: z.tyack@uq.edu.au or zephanie.tyack@gmail.com (Z. Tyack).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com).

S.J. Chester and Z. Tyack contributed equally to this paper.

Received March 09, 2017

Received in revised form May 05, 2018

Accepted May 07, 2018

© 2018 International Association for the Study of Pain
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