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Effects of Age on Responsiveness to Adjunct Hypnotic Analgesia During Invasive Medical Procedures

Lutgendorf, Susan K. PhD; Lang, Elvira V. MD; Berbaum, Kevin S. PhD; Russell, Daniel PhD; Berbaum, Michael L. PhD; Logan, Henrietta PhD; Benotsch, Eric G. PhD; Schulz-Stubner, Sebastian MD; Turesky, Derek MA; Spiegel, David MD

doi: 10.1097/PSY.0b013e31803133ea
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Objectives: To assess the effects of age on responsiveness to self-hypnotic relaxation as an analgesic adjunct in patients undergoing invasive medical procedures.

Material and Methods: Secondary data analysis from a prospective trial with 241 patients randomized to receive hypnosis, attention, and standard care treatment during interventional radiological procedures. Growth curve analyses, hierarchical linear regressions, and logistic regressions using orthogonal contrasts were used for analysis. Outcome measures were Hypnotic Induction Profile scores, self-reported pain and anxiety, medication use, oxygen desaturation ≤89%, and procedure time.

Results: Hypnotizability did not vary with age (p = .19). Patients receiving attention and hypnosis had greater pain reduction during the procedure (p = .02), with trends toward lower pain with hypnosis (p = .07); this did not differ by age. As age increased, patients experienced more rapid pain control with hypnosis (p = .03). There was more rapid anxiety reduction with attention and hypnosis (p = .03). Trends toward lower final anxiety were also observed with attention and hypnosis versus standard care (p = .08), and with hypnosis versus attention (p = .059); these relationships did not differ by age. Patients requested and received less medication and had less oxygen desaturation ≤89% with attention and hypnosis (p < .001); this did not differ by age. However, as age increased, oxygen desaturation was greater in standard care (p = .03). Procedure time was reduced in the attention and hypnosis groups (p = .007); this did not vary by age.

Conclusions: Older patients are hypnotizable and increasing age does not appear to mitigate the usefulness of hypnotic analgesia during invasive medical procedures.

ln = natural log; REML = restricted maximum likelihood; mg = milligram; μg = microgram; ASA Class = American Society of Anesthesiologists Physical Status Classification; HIP = Hypnotic Induction Profile.

From the Department of Psychology (S.K.L., D.T.), University of Iowa; the Department of Radiology, Iowa City, Iowa Beth Israel Deaconess Medical Center (E.V.L.), Harvard Medical School, Boston, Massachusetts; the Department of Radiology (K.S.B.), University of Iowa, Iowa City, Iowa; Institute for Social and Behavioral Research (D.R.), Iowa State University, Ames, Iowa; Institute for Health Research and Policy (M.L.B.), University of Illinois at Chicago, Chicago, Illinois; the Division of Public Health Services and Research (H.L.), University of Florida, Gainesville, Florida; the Department of Psychology (E.G.B.), University of Colorado, Denver, Colorado; the Department of Anesthesiology (S.S.-S.), University of Iowa, Iowa City, Iowa; the Department of Psychiatry and Behavioral Sciences (D.S.), Stanford University, Stanford, California.

Address correspondence and reprint requests to Susan K. Lutgendorf, Department of Psychology, University of Iowa, E11 Seashore Hall, Iowa City, IA 52242. E-mail: susan-lutgendorf@uiowa.edu

Received for publication November 26, 2005; revision received September 29, 2006.

This work was supported in part by Grants 1RO1 AT 0002-05 and 1K24 AT 01074-01 from the National Institutes of Health, National Center for Complementary and Alternative Medicine (E.V.L.), and by grants P20 AT-756 and R21 CA102515 (S.L.).

Copyright © 2007 by American Psychosomatic Society
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