Hypnosis for Postoperative Pain Management of Thoracoscopic Approach to Repair Pectus Excavatum: Retrospective Analysis. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Manworren, Renee C. B.; Girard, Eric; Verissimo, Ana Maria; Ruscher, Kimberly A.; Santanelli, James P.; Weiss, Richard; Hight, Donald
• Is Part Of: Journal of pediatric surgical nursing. Volume 4:Issue 2(2015)
• Publication Date: 2015-04
• Subjects: adolescents -- hypnosis -- Nuss procedure -- pectus excavatum -- postoperative pain; Pediatric nursing -- Periodicals; Children -- Surgery -- Nursing -- Periodicals; 617.980231
• DOI: 10.1097/JPS.0000000000000061
• Languages: English
• ISSNs: 2332-0249

Abstract

Abstract : Introduction: Nuss procedure, a minimally invasive thoracoscopic approach to repair pectus excavatum, results in a smaller scar but significant pain. The purpose of this Institutional Review Board-approved retrospective study was to compare postoperative pain management outcomes of adolescents who self-selected to receive or not receive preoperative self-hypnosis training before Nuss procedure. Self-hypnosis, an integrative medicine approach to pain management, may be more effective than traditional analgesics alone for managing postoperative pain. Methods: In 2011, 8 of 22 patients who underwent Nuss procedure received preoperative self-hypnosis training and postoperative self-hypnosis coaching. Postoperatively, patients received epidural analgesia with local anesthetic, intravenous patient-controlled opioid analgesia, and intravenous nonsteroidal anti-inflammatory drugs and transitioned to oral opioids and nonsteroidal anti-inflammatory drugs. Results: Self-hypnosis training was associated with use of fewer milligrams per hour of morphine equivalents ( p = .005) and lower mean pain intensity over the first 5 days of hospital stay ( p = .041). Despite the opioid-sparing effect of self-hypnosis training, nausea, vomiting, constipation, and hypoventilation were adverse effects experienced by patients in both groups. Discussion: The results of this retrospective study suggest that self-hypnosis provides an opioid-sparing effect for managing moderate-to-severe pediatric postoperative pain after Nuss procedure. Further clinical studies are needed to validate the effectiveness of self-hypnosis for symptom management after painful pediatric surgical procedures.