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Scientific Papers - Adjunctive Self-hypnotic Relaxation during Image-guided Large Core Needle Biopsy of the Breast: A Prospective Randomized Trial

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PARTICIPANTS
Presenter
Elvira Lang MD  
Abstract Co-Author
Kevin Berbaum PhD  
Salomao Faintuch MD  
Olga Hatsiopoulou MD  
Michael Berbaum PhD  
Janet Baum MD  
et al  
  CODE: SSM01-04
  SESSION: Breast Imaging (Interventional)
  Adjunctive Self-hypnotic Relaxation during Image-guided Large Core Needle Biopsy of the Breast: A Prospective Randomized Trial
 
 
  DATE: Wednesday, November 29 2006
  START TIME: 03:30 PM
  END TIME: 03:40 PM
  LOCATION: Arie Crown Theater



  DISCLOSURES
  E.L. - Nothing to disclose.  
  K.B. - Nothing to disclose.  
  S.F. - Nothing to disclose.  
  O.H. - Nothing to disclose.  
  M.B. - Nothing to disclose.  
  J.B. - Consultant, iCAD, Inc  
  .e.  

 PURPOSE
 
To assess whether adjunct self-hypnotic relaxation reduces pain and anxiety during image-guided large core needle biopsy of the breast (LCNB).
  
 METHOD AND MATERIALS
 
236 women referred for LCNB to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during LCNB. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, compared in an ordinal logistic regression model.
  
 RESULTS
 
Women presented with elevated anxiety. Anxiety increased further significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = –0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = –0.27, p < 0.001). Anxiety increased more with standard care than empathy and hypnosis and decreased more with hypnosis than empathy (all p < 0.01). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional provider: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis.
  
 CONCLUSION
 
While both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost.
  
 CLINICAL RELEVANCE/APPLICATION
 
Self hypnotic relaxation offers patients during large core needle breast biopsy a drug free choice for reducing pain and anxiety without adding procedure time, cost, or side effects.
  
QUESTIONS ABOUT THIS EVENT EMAIL:
   elang@bidmc.harvard.edu
   
   
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