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Objective:
The minimally invasive approach to repair of pectus excavatum results in significant pain. An integrative medicine approach to post-surgical pain management may be more effective than traditional analgesics alone. This retrospective study compared the post-operative pain management outcomes of adolescents who selected to undergo pre-operative self-hypnosis training to those who did not.
Design:
Retrospective case controlled study
Setting:
Children’s Hospital
Patients:
A convenience sample of all patients between 10-18 years of age who underwent minimally invasive repair of pectus excavatum in 2011 was reviewed retrospectively. 8 of the 22 patients received self-hypnosis training. Patients received post-operative epidural analgesia with local anesthetic, patient-controlled opioid analgesia, intravenous ketorolac, with transitioning to oral opioids and ibuprofen. No patients were excluded.
Interventions:
Pre-operative self-hypnosis training by an integrative medicine physician.
Main Outcome Measure:
The main outcome measure was pain control as measured by milligrams of morphine or morphine equivalent used and mean reported pain scores.
Results:
Patients who received pre-operative self-hypnosis training used fewer milligrams of morphine or morphine equivalents per hour (Z=-2.521, p=0.012) and reported a lower mean pain score over the first five days of their hospital stay (Z=-2.04, p=0.041).
Conclusion:
The results of this retrospective study suggest hypnosis provides an opioid-sparing effect for managing moderate to severe post-operative pain after minimally invasive repair of pectus excavatum. A randomized clinical trial is needed to validate the effectiveness of hypnosis for symptom management after painful pediatric surgical procedures.