Analgesic efficacy of clinical hypnosis in pediatric patients following orthopedic surgery.

INTRODUCTION: Clinical hypnosis is effective for pain management in adults, but there is little evidence of its use in the pediatric population. MATERIALS AND METHODS: We conducted a randomized clinical trial on pediatric patients (aged 7-19 years) that had undergone major orthopedic surgery, allocated to one of two groups: the experimental hypnosis group (HG), which received two sessions of clinical hypnosis, or the control group (CG), which had two non-hypnosis visits. The variables analyzed were pain (Visual Analog Scale [VAS]), use of analgesic drugs, anxiety (State-Trait Anxiety Inventory for Children [STAIC]), parasympathetic activation (Analgesia Nociception Index [ANI] monitor) and vital signs such as heart rate (HR), respiratory rate (RR) and systolic and diastolic blood pressure (SBP and DBP). We used the Student t test and the χ2 test for the statistical analysis. RESULTS: Of the 24 patients in the sample, 16 were assigned to the HG and 8 to the CG. In the HG, we observed a significant reduction in VAS scores at 24 h (P = .0001) and 48 h (P = .0004) post surgery. Additionally, HG patients required fewer rescue doses of analgesic agents (P = .025) and had lower state-anxiety scale scores in the STAIC (P = .046). The ANI values increased significantly at 24 h (P = .0001) and 48 h (P = .007). The HR, SBP and DBP values decreased at 24 h (P < .05), and the RR at 24 and 48 h (P < .05). CONCLUSION: Clinical hypnosis is an effective nonpharmacological intervention for reducing postoperative pain and anxiety in children, and it is associated with an increase in parasympathetic tone.