AUTHOR=Azam Muhammad Abid , Weinrib Aliza Z. , Slepian P. Maxwell , Rosenbloom Brittany N. , Waisman Anna , Clarke Hance , Katz Joel 

TITLE=Effects of perioperative clinical hypnosis on heart rate variability in patients undergoing oncologic surgery: secondary outcomes of a randomized controlled trial

JOURNAL=Frontiers in Pain Research

VOLUME=5

YEAR=2024

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2024.1354015

DOI=10.3389/fpain.2024.1354015

ISSN=2673-561X

ABSTRACT=<sec><title>Introduction</title><p>Clinical hypnosis has been proposed for post-surgical pain management for its potential vagal-mediated anti-inflammatory properties. Evidence is needed to understand its effectiveness for post-surgical recovery. Iin this secondary outcome study, it was hypothesized that surgical oncology patients randomized to receive perioperative clinical hypnosis (CH) would demonstrate greater heart-rate variability (HRV) during rest and relaxation at a 1-month post-surgery assessment compared to a treatment-as-usual group (TAU).</p></sec><sec><title>Methods</title><p>After REB approval, trial registration and informed consent, 92 participants were randomized to receive CH (<italic>n</italic> = 45) or TAU (<italic>n</italic> = 47). CH participants received a CH session before surgery and during post-surgical in-hospital stay HRV was assessed during rest (5 min) and relaxation (10 min) before and 1-month after surgery. Pain intensity was obtained using a 0–10 numeric rating scale pre and post 1-week and 1-month post surgery.</p></sec><sec><title>Results</title><p>One month after surgery, HRV was significantly higher in CH group (<italic>n</italic> = 29) during rest and relaxation (both <italic>p</italic> &lt; 0.05, <italic>d</italic> = 0.73) than TAU group (<italic>n</italic> = 28). By contrast, rest and relaxation HRV decreased from pre- to 1-month post-surgery for the TAU (both <italic>p</italic> &lt; 0.001, <italic>d</italic> &gt; 0.48) but not the CH group. Pain intensity increased from pre-surgery to 1-week post-surgery (<italic>p</italic> &lt; 0.001, <italic>d</italic> = 0.50), and decreased from 1-week to 1-month post-surgery (<italic>p</italic> = 0.005, <italic>d</italic> = 0.21) for all participants.</p></sec><sec><title>Discussion</title><p>The results suggest that hypnosis prevents the deleterious effects of surgery on HRV by preserving pre-operative vagal activity. These findings underscore the potential of clinical hypnosis in mitigating the adverse effects of surgery on autonomic function and may have significant implications for enhancing post-surgical recovery and pain management strategies.</p></sec><sec><title>Clinical Trial Registration</title><p><ext-link ext-link-type="uri" xlink:href="https://ClinicalTrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">ClinicalTrials.gov</ext-link>, identifier (NCT03730350).</p></sec>