Hypnosis and Burns


A number of studies have shown that hypnosis can reduce the pain experienced during a variety of medical conditions including burn-wound debridement, [1]. The International Journal of Clinical and Experimental Hypnosis found that hypnosis relieved the pain of 75% of 933 subjects participating in 27 different experiments.[2]

Hypnosis is effective in reducing pain from and coping with cancer and other chronic conditions. Nausea and other symptoms related to incurable diseases may also be managed with hypnosis.[3]

For some psychologists who uphold the altered state theory of hypnosis, pain relief in response to hypnosis is said to be the result of the brain’s dual-processing functionality. This effect is obtained either through the process of selective attention or dissociation, in which both theories involve the presence of activity in pain receptive regions of the brain, and a difference in the processing of the stimuli by the hypnotised subject.[4]

The American Psychological Association published a study comparing the effects of hypnosis, ordinary suggestion and placebo in reducing pain. The study found that highly suggestible individuals experienced a greater reduction in pain from hypnosis compared with placebo, whereas less suggestible subjects experienced no pain reduction from hypnosis when compared with placebo. Ordinary non-hypnotic suggestion also caused reduction in pain compared to placebo, but was able to reduce pain in a wider range of subjects (both high and low suggestible) than hypnosis. The results showed that it is primarily the subject’s responsiveness to suggestion, whether within the context of hypnosis or not, that is the main determinant of causing reduction in pain.[5]

Burns Table

Study 1: Hypnosis to Control Pain of Burn Patients
An Experimental Study of Hypnosis in Painful Burns
http://www.tandfonline.com/doi/abs/10.1080/00029157.1978.10403952#preview

Results: Both studies revealed significantly lower percentages of medication used (p < .01) by the hypnotic groups than control groups.

Notes: The present study examines the usefulness of hypnosis in the control of acute pain in thermal and electrically burned patients as an adjunctive analgesic during the routine care of burn wounds. It was hypothesized that the use of hypnosis would lead to significant reductions in the amount of drugs needed as compared to patients using medication only. Anxiety and discomfort associated with daily tanking, debridement, and dressing changes were expected to be reduced because of the introduction of hypnotic procedures. The experimental study also examined the variables of age and percent of burns. Two studies were conducted including patients with 0-30% total body burns and 31-60% burns. A variety of hypnotic techniques were used.

American Journal of Clinical Hypnosis. Vol 21(1), Jul 1978, 3-12
By: John R. Wakeman, Jerold Z. Kaplan, Department of Psychiatry, Brooke Army Medical Center, USA, U.S. Army Institute of Surgical Research, Brooke Army Medical Center, USA, Psychology Service, Department of Psychiatry, Brooke Army Medical Center, Fort Sam Houston, Texas, USA)

Study 2: Hypnosis to Control Pain During Burn Wound Debridement
Hypnosis for the treatment of burn pain
http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&uid=1993-06886-001

Results: Only hypnotized subjects reported significant pain reductions relative to pre-treatment baseline. This result was corroborated by nurse VAS ratings. Findings indicate that hypnosis is a viable adjunct treatment for burn pain.

Notes: Investigated the clinical utility of hypnosis for controlling pain during wound debridement (removal of unhealthy tissue from a wound to promote healing). Thirty hospitalized burn patients and their nurses submitted visual analog scales (VASs) for pain during 2 consecutive daily wound debridements. On the 1st day, patients and nurses submitted baseline VAS ratings. Before the next day’s wound debridement, subjects received hypnosis, attention and information, or no treatment.

Journal of Consulting and Clinical Psychology, Vol 60(5), Oct 1992, 713-717
By: David R. Patterson, John J. Everett, G. Leonard Burns, Janet A. Marvin, Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, USA

burns

Study 3: Hypnosis to Reduce Anxiety Before and During Dressing Changes of Burn Patients
Psychological approaches during dressing changes of burned patients: a prospective randomised study comparing hypnosis against stress reducing strategy
http://www.sciencedirect.com/science/article/pii/S0305417901000353

Results: The comparison of the two treatment groups indicated that VAS anxiety scores were significantly decreased before and during dressing changes when the hypnotic technique was used instead of stress reducing strategies (SRS).

Notes: A prospective study was designed to compare two psychological support interventions in controlling peri-dressing change pain and anxiety in severely burned patients. Thirty patients with a total burned surface area of 10-25%, requiring a hospital stay of at least 14 days, were randomized to receive either hypnosis or stress reducing strategies (SRS) adjunctively to routine intramuscular pre-dressing change analgesia and anxiolytic drugs. Visual analogue scale (VAS) scores for anxiety, pain, pain control and satisfaction were recorded at 2-day intervals throughout the 14-day study period, before, during and after dressing changes.

Burns, Volume 27, Issue 8, December 2001, Pages 793-799
By: Marie-Christine Frenay, Marie-Elisabeth Faymonville, Sabine Devlieger, Adelin Albert, Alain Vanderkelen, Burn Centre, Military Hospital Queen Astrid, Rue Bruyn, 1, 1120 Brussels, Belgium, Department of Anesthesiology, University Hospital, Liège, Belgium, Department of Biostatistics, University Hospital, Liège, Belgium

Study 4: Hypnosis for Pain in Severe Burn Patients
Hypnosis and pain in patients with severe burns: a pilot study
http://europepmc.org/abstract/MED/3228699

Results: Results show a 50-64 percent decrease in reported pain level for three patients and a 52 percent increase of pain for one patient. The mean decrease for these four patients was 30 percent (for overall as well as worst pain during dressing changes). A 30 percent reduction of anxiety level and a modest reduction of medication use were achieved concurrently. It is concluded that hypnosis is of potential value during dressing changes of burn patients.

Notes: This report presents a pilot study on the effectiveness of hypnosis in the control of pain during dressing changes of burn patients. Eight patients were treated, and all evaluated the interventions as beneficial. The treatment of four patients was more closely analyzed by obtaining pain and anxiety ratings daily.

Burns, Including Thermal Injury, 1988, 14(5):399-404
By: A. J. Van der Does, R. Van Dyck, R. E. Spijker, Burn Centre, Red Cross Hospital, Beverwijk, The Netherlands

180px-Burn_Degree_Diagram

Study 5: Hypnosis for Burn Pain – Review of Six Studies
Medical hypnosis for pain and psychological distress during burn wound debridement: a critical review
http://www.oapublishinglondon.com/article/540

Results: The results of these studies suggest that hypnosis may be more effective than structured attention for reducing patients’ pain and anxiety levels during wound debridement. The existing evidence suggests that hypnosis may be effective in managing pain and distress for burn victims who have difficulty coping during wound debridement.

Notes: This article offers a critical review of the literature currently available on the efficacy of medical hypnosis for managing pain and distress during burn wound debridement. Six studies involving a total of 217 participants met inclusion criteria and are discussed in detail.

OA Alternative Medicine 2013 Apr 01;1(1):10
By: J. Sliwinski, W. Fisher, A. Johnson, G. Elkins, Baylor University Mind-Body Medicine Research Lab, Waco, Texas, USA

Additional References:

  1. Patterson, David R.; Questad, Kent A.; De Lateur, Barbara J. (1989). “Hypnotherapy as an adjunct to narcotic analgesia for the treatment of pain for burn debridement”. American Journal of Clinical Hypnosis 31 (3): 156–163.
  2. Nash, Michael R. “The Truth and the Hype of Hypnosis”. Scientific American: July 2001
  3. Kwekkeboom, K.L.; Gretarsdottir, E. (2006). “Systematic review of relaxation interventions for pain”. Journal of Nursing Scholarship 38 (3): 269–277.
  4. Myers, David G. (2014). Psychology: Tenth Edition in Modules (10th ed.). Worth Publishers. pp. 112–13.
  5. “Hypnosis, suggestion, and placebo in the reduction of experimental pain” faqs.org

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