The effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety.

INTRODUCTION: Several studies evaluating the tolerance of transrectal ultrasound (TRUS)-guided needle biopsies showed that moderate-to-severe pain was associated with the procedure. Additionally, prebiopsy anxiety or rebiopsy as a result of a prior biopsy procedure is mentioned as factors predisposing to higher pain intensity. Thus, in this study, we investigated the effects of hypnotherapy during transrectal ultrasound-guided prostate needle biopsy for pain and anxiety. MATERIALS AND METHODS: Sixty-four patients presenting for TRUS-guided prostate needle biopsy were randomly assigned to receive either 10-min presurgery hypnosis session (n = 32, mean age 63.5 ± 6.1, p = 0.289) or a presurgery control session (n = 32, mean age 61.8 ± 6.8, p = 0.289). The hypnosis session involved suggestions for increased relaxation and decreased anxiety. Presurgery pain and anxiety were measured using visual analog scales (VAS), Beck Anxiety Inventory (BAI), and Hamilton Anxiety Scale (HAS), respectively. In our statistics, p < 0.05 was considered statistically significant. RESULTS: Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS [mean 1 (0-8); p = 0.011], BAI (6.0 vs 2.0; p < 0.001), and HAS (11.0 vs 6.0; p < 0.001). CONCLUSION: The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical anxiety, and therefore pain, in patients awaiting diagnostic prostate cancer surgery.

The effects of hypnosis on heart rate variability.

Uslu et al. (2012 ) suggested that hypnotic status can modulate cerebral blood flow. The authors investigated the effects of hypnosis on heart rate variability (HRV). In women, HRV decreased during hypnosis. Posthypnotic values were higher compared to prehypnotic and hypnotic values. Women had highest HRV parameters in the posthypnotic condition. It appears that hypnosis can produce cardiac and cognitive activations. Hypnotherapy may be useful in some cardiac clinical conditions characterized by an autonomic imbalance or some cardiac arrhythmias.

Cerebral blood flow evaluation during the hypnotic state with transcranial Doppler sonography.

Cerebral blood flow was measured in normal waking (alert relaxed mental imagery) and hypnotic states. Mean flow velocity (Vm) in the middle cerebral artery (MCA) was significantly increased in hypnosis (Condition II) from Condition I (5 minutes before hypnotic induction). Vm decreased in Condition III (hypnotic imagination). After hypnosis, Vm values returned to baseline. Pulsatility index values and resistive index values showed significant variations during sonographic monitoring between Conditions I and IV (5 minutes after the completion of hypnosis). Both values were significantly higher in Condition I than IV. These findings show that hypnotic status can modulate cerebral blood flow.