Contribution of Hypnosis in Guided Hepatic Biopsy (Ap-Hy-PBH)

Assistance Publique - Hôpitaux de Paris

Status

Completed

Conditions

Ultrasound-guided Hepatic Biopsy

Treatments

Behavioral: Hypnoanalgésia

Study type

Interventional

Funder types

Other

Identifiers

NCT05413174

APHP220124

2022-A00008-35 (Other Identifier)

Details and patient eligibility

About

The purpose of this study is to evaluate the contribution of hypnosis on the level of pain felt by the patient during ultrasound-guided hepatic biopsy, by comparing an intervention group (hypnosis) to a control group (routine and benevolent care).

Single-center randomized controlled trial.

Full description

Hepatic Biopsy Puncture (HBP) is a very useful procedure for the assessment of chronic liver disease as well as in certain acute situations, and is also essential in oncology for the histological diagnosis of primary and secondary focal lesions. A study on the prevalence and characteristics of induced pain shows that it is a pain-generating procedure for 84% of patients and that the combination of anxiolytics and local anesthesia is insufficient. The effect of relaxing therapies was evaluated during percutaneous interventional radiology procedures. Anxiety and pain measured with visual analogue scales were significantly reduced in the group receiving support from sophrology and hypnosis . The mean evaluation of anxiety per procedure was 2.07 (95% CI, 1.48-2.82) in the group receiving relaxation therapy compared with 5.94 (95% CI, 4.62-7.22) in the other group. The mean level of pain felt was 1.83 (95% CI, 1.23-2.78) for the accompanied procedures versus 4.16 (95% CI, 2.53-6.04) without accompaniment. However, this study did not specifically look at percutaneous liver biopsy, and moreover the relaxation technique used was based on sophrology and not on an Ericksonian hypnosis approach.

Data concerning the use of hypnosis during percutaneous liver biopsies are limited to clinical cases, which report an absence of pain felt, including an observation in a patient who did not receive local anesthesia because of a history of allergy to Lidocaine.

Training in attentive and benevolent patient care already allows this type of procedure to be performed under good conditions in our department. This training of about one hour, carried out internally, does not require specific means. It would therefore seem useful to see what the impact is of using Ericksonian hypnosis, a recognized and risk-free technique which would require longer specific training for the staff and would represent a cost.

Enrollment

70 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria:

Patients with an indication for ultrasound-guided hepatic biopsy
Over 18 years of age
Affiliated to a social security system

Exclusion Criteria

History of psychiatric pathology, psychotropic or anxiolytic treatments
Refusal to participate.
People who do not understand and/or speak French.
People who are deaf
Patients with impaired cognitive abilities, evaluated by the prescribing service
Disorders of hemostasis against percutaneous approach
Allergy to Lidocaine
Patient under National Health Aids