Suturing is a daily practice in the emergency department, but it can be painful and stressful for patients. Hypnosis is increasingly used as a complement to the usual painkillers. The aim of our study was to investigate the impact of hypnosis on stitch placement in emergency department patients presenting with lacerations assessed by heart rate variability.
The aim of this randomized, controlled, single-center, prospective study is to evaluate the impact of hypnosis during stitching in emergency department patients presenting with a laceration assessed by heart rate variability. All patients with eligibility criteria will be included if the patient gave his written consent. Patients will be randomized to one of two arms: (1) Hypnosis or (2) Standard Of Care (SOC) A heart rate monitoring belt will be fitted to the patient for both groups. The patient will be asked to complete a self-assessment questionnaire on pain and stress, as well as socio-demographic parameters. A blood sample will be collected and the heart rate and blood pressure will be measured. Stitches will be taken with or without hypnosis, and after 30 minutes, the pain and stress self-assessment questionnaire will again be completed by the patient, and a new blood test will be taken. the heart rate monitoring belt will be removed, and the study will be completed for the patient.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
180
Before the beginning of stitches, the patient will be offered a hypnotic induction. The hypnotic induction is the initial phase of the hypnosis process. Its goal is to bring the patient to a state of dissociation: the hypnotic trance. Induction is usually achieved through progressive relaxation, sensory focusing, and a process of confusion.
CHU de Clermont-Ferrand
Clermont-Ferrand, France
RECRUITINGHeart rate variability
The heart rate variability will be measured using Bittium Faros
Time frame: Hour 0
Changes on visual analog scale of pain and stress
Visual analog scale (VAS) of pain and stress will be performed at two different times by the patient. A VAS is a 100-mm long horizontal line with verbal descriptors at each end to express the extremes of the feeling. Patients mark the point on the line that best corresponds to their pain and severity between 0 (no symptoms) to 100 (the worst pain and stress). Cut points on the pain VAS : no pain or low pain (0-29 mm), moderate pain (30-59 mm), and severe pain (\>59 mm). Cut points on the stress VAS : no pain or low stress (0-19 mm), moderate stress (19-49 mm), severe stress (50-81 mm), and at-risk stress (\>81 mm).
Time frame: Hour 0; Hour 0+30 minutes
Evaluation of stress biomarkers in blood samples
Evaluation of cortisol, DHEA, DHEA-s, ghrelin, leptin, TNF-alpha, epinephrin, norepinephrine, dopamine
Time frame: Hour 0; Hour 0+30 minutes
Evaluation of blood pressure
Evaluation of hypnosis impact on systolic and diastolic blood pressure in millimeter of mercury (mmHg)
Time frame: Hour 0; Hour 0+30 minutes
Evaluation of heart rate
Evaluation of hypnosis impact on physiological parameters heart rate in beats per minute (bpm)
Time frame: Hour 0; Hour 0+30 minutes
Impact of sociodemographics parameters on pain and stress
Evaluation of the impact of sociodemographics parameters on pain and stress evaluated by the visual analog scale (VAS) performed at two different times (outcome N°2)
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Time frame: Hour 0; Hour 0+30 minutes
Impact of location of the wound on pain and stress
Evaluation of the impact of location of the wound on stress and pain evaluated by the visual analog scale (outcome n°2)
Time frame: Hour 0; Hour 0+30 minutes
Impact of location of the wound on variability of heart frequency
Evaluation of the impact of location of the wound on the variability of heart frequency measured by Bittium Faros (outcome n°1)
Time frame: Hour 0; Hour 0+30 minutes
Impact of the length of the wound on pain and stress
Evaluation of the impact of the length of the wound on stress and pain evaluated by the visual analog scale (outcome n°2)
Time frame: Hour 0; Hour 0+30 minutes
Impact of the length of the wound on variability of heart frequency
Evaluation of the impact of the length of the wound on the variability of heart frequency measured by heart rate monitoring belt (outcome n°1)
Time frame: Hour 0; Hour 0+30 minutes
Impact of the depth of the wound on pain and stress
Evaluation of the impact of the depth of the wound on stress and pain evaluated by the visual analog scale (outcome n°2)
Time frame: Hour 0; Hour 0+30 minutes
Impact of the depth of the wound on pain and stress
Evaluation of the impact of the depth of the wound on the variability of heart frequency measured by heart rate monitoring belt (outcome n°1)
Time frame: Hour 0; Hour 0+30 minutes