BACKGROUND

Patients undergoing major oncological surgery in the cervical and facial district, after surgery are managed with a specific protocol which provides standard therapy with an elastomeric pump, timed therapy and Rescue Dose if the patient feels pain NRS > 3 (Numerical Rating Scale). In the ward several nurses are trained in the hypnosis technique, a procedure in which the patient experiences change on a sensorial and behavioral level. Given the strong connection between the mind and the body, hypnosis therapy is particularly effective to reach a generalized, physical and psychological well – being. For this reason, in the management of postoperative pain we wanted to test the synergy between hypnosis therapy and the pain analgesic protocol in use.

METHODS

From March 2023 to March 2024, n. 24 patients were observed (n. 18 men and n. 6 women) with an average age of 61 years, undergoing major oncological surgery in the cervical-facial district.

The protocol in use consist in, if Numerical Rating Scale > 3, the administration of Tramadol 50 mg in 100 ml saline solution 0,9% to be make maximum twice a day at a distance of eight hours between one administration and the next.

In this study, if Numerical Rating Scale > 3, we administered hypnosis therapy and, if the patients did not benefit from it, rescue dose with Tramadol was administered at the doses foreseen by the antalgic protocol.

Inclusion Criteria:

• Adult patients with Numerical Rating Scale > 3 and who are treated with analgesic protocol

Exclusion Criteria:

• Patients with cognitive deficits and psychiatric disease

RESULTS

• Patients who have received the pharmacological Rescue Dose: n. 4
• Total pharmacological Rescue Dose administered: n. 4
• Average pain pre – rescue dose: NRS = 5
• Average pain post – rescue dose: NRS = 2
• Benefit hypnosis rescue dose: n. 14/18

CONCLUSION

From the analysis of the data, emerges that the pain, after the rescue dose with hypnosis, appears to be well controlled, with average values ​​that are below the limit of NRS < 3 and with a pre and post treatment reduction of three Numerical Rating Scale points. The protocol created in synergy between anesthetists, nurses and otolaryngology specialists, was found to be both effective and safe. Good pain control had positive repercussions on the patient's quality of life, early recovery of autonomy and his hospitalization experience.

REFERENCES

Maindet C, Burnod A, Minello C, George B, Allano G, Lemaire A. Strategies of complementary and integrative therapies in cancer-related pain-attaining exhaustive cancer pain management. Support are Cancer; 2019; 27(8):3119-32.

Carlson LE, Toivonen K, Flynn M, Deleemans J, Piedalue KA, Tolsdorf E et al. The role of hypnosis in cancer care. Current Oncology Reports; 2018; 20(12):93.

Sine H, Achbani A, Filali K. The Effect of Hypnosis on the Intensity of Pain and Anxiety in Cancer Patients: A Systematic Review of Controlled Experimental Trials. Cancer Investigation; 2022; 40(3):235-253.