Interest of a standardized hypnotic message for the reduction of pain and anxiety in cancer patients treated by capsaicin patch for neuropathic pain: a randomized controlled trial

Rémi Etienne, Myriam Laurent, Aline Henry, Antoine Bioy, Julia Salleron, Cécile Huin Schohn, Nathalie Cretineau, Rémi Etienne, Myriam Laurent, Aline Henry, Antoine Bioy, Julia Salleron, Cécile Huin Schohn, Nathalie Cretineau

Abstract

Background: Neuropathic pain is characterized by spontaneous painful symptoms. Medical therapies include the use of a capsaicin 8% patch (Qutenza®, Grünenthal Gmbh, Germany), and patients may experience a sharp burning sensation at application and removal of the patch. This study aimed to evaluate the impact of playing a standardized hypnosis recording during application, on the pain and anxiety induced by capsaicin treatment.

Methods: In a randomized, controlled trial, we assessed the benefits of the intervention firstly on pain and secondly on anxiety, as measured using numerical rating scales. All patients had application of the capsaicin patch, including the possibility for the patient to apply a cold patch. Participants were randomly assigned to one of 3 groups, namely the "Standard group" (no intervention), "Hypnosis group", in which a standardized hypnotic message was played during application, or the "Music group" in which relaxing music was played during application of the patch.

Results: Sixty-nine patients were included. Overall, there was no significant difference in pain scores between groups (p = 0.355). Compared to standard application, anxiety was significantly lower in the hypnosis group after application (p = 0.007), with no significant difference between the standard and music arms (p = 0.271), or between the hypnosis and music arms (p = 0.423).

Conclusions: Listening to a standardized hypnotic message during application of a capsaicin patch was found to significantly lower anxiety. These findings indicate that the use of a hypnotic message can reduce discomfort and warrant its evaluation in other indications of pain or anxiety during treatment procedures.

Trial registration: NCT02822625 .

Keywords: Anxiety; Cancer; Hypnosis; Music therapy; Pain.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of the study design
Fig. 2
Fig. 2
Flow Diagram

References

    1. Pickering G, Martin E, Tiberghien F, Delorme C, Mick G. Localized neuropathic pain: an expert consensus on local treatments. Drug Des Devel Ther. 2017;11:2709–2718. doi: 10.2147/DDDT.S142630.
    1. Mick G, Correa-Illanes G. Topical pain management with the 5% lidocaine medicated plaster--a review. Curr Med Res Opin. 2012;28(6):937–951. doi: 10.1185/03007995.2012.690339.
    1. Wallace M, Pappagallo M. Qutenza(R): a capsaicin 8% patch for the management of postherpetic neuralgia. Expert Rev Neurother. 2011;11(1):15–27. doi: 10.1586/ern.10.182.
    1. Tiberghien-Chatelain F, Laventurier S, Piccand V, Lajoie JL, Lassauge F. Efficacité du patch de capsaïcine 8% Qutenza® Sur les 26 premiers patients traités au CHU de Besançon [efficacy of the Qutenza® capsaicin 8% patch in the first 26 patients treated at the University Hospital of Besançon] Douleurs : Evaluation - Diagnostic - Traitement. 2014;15(6):288–303.
    1. Kennedy WR, Vanhove GF, Lu SP, Tobias J, Bley KR, Walk D, Wendelschafer-Crabb G, Simone DA, Selim MM. A randomized, controlled, open-label study of the long-term effects of NGX-4010, a high-concentration capsaicin patch, on epidermal nerve fiber density and sensory function in healthy volunteers. J Pain. 2010;11(6):579–587. doi: 10.1016/j.jpain.2009.09.019.
    1. Anand P, Bley K. Topical capsaicin for pain management: therapeutic potential and mechanisms of action of the new high-concentration capsaicin 8% patch. Br J Anaesth. 2011;107(4):490–502. doi: 10.1093/bja/aer260.
    1. Backonja M, Wallace MS, Blonsky ER, Cutler BJ, Malan P, Jr, Rauck R, Tobias J, Group N-CS NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: a randomised, double-blind study. Lancet Neurol. 2008;7(12):1106–1112. doi: 10.1016/S1474-4422(08)70228-X.
    1. Blair HA. Capsaicin 8% dermal patch: a review in peripheral neuropathic pain. Drugs. 2018;78(14):1489–1500. doi: 10.1007/s40265-018-0982-7.
    1. Faymonville ME, Roediger L, Del Fiore G, Delgueldre C, Phillips C, Lamy M, Luxen A, Maquet P, Laureys S. Increased cerebral functional connectivity underlying the antinociceptive effects of hypnosis. Brain Res Cogn Brain Res. 2003;17(2):255–262. doi: 10.1016/S0926-6410(03)00113-7.
    1. Kendrick C, Sliwinski J, Yu Y, Johnson A, Fisher W, Kekecs Z, Elkins G. Hypnosis for acute procedural pain: a critical review. Int J Clin Exp Hypn. 2016;64(1):75–115. doi: 10.1080/00207144.2015.1099405.
    1. Jafarizadeh H, Lotfi M, Ajoudani F, Kiani A, Alinejad V. Hypnosis for reduction of background pain and pain anxiety in men with burns: a blinded, randomised, placebo-controlled study. Burns. 2018;44(1):108–117. doi: 10.1016/j.burns.2017.06.001.
    1. Roberts RL, Kekecs Z, Lazott L, Toor OH, Elkins GR. Hypnosis for burn-related pain: case studies and a review of the literature. World J Anesthesiol. 2017;6(1):1–13. doi: 10.5313/wja.v6.i1.1.
    1. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short Form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP) Arthritis Care Res (Hoboken) 2011;63(Suppl 11):S240–S252. doi: 10.1002/acr.20543.
    1. Davey HM, Barratt AL, Butow PN, Deeks JJ. A one-item question with a Likert or visual analog scale adequately measured current anxiety. J Clin Epidemiol. 2007;60(4):356–360. doi: 10.1016/j.jclinepi.2006.07.015.
    1. Hole J, Hirsch M, Ball E, Meads C. Music as an aid for postoperative recovery in adults: a systematic review and meta-analysis. Lancet. 2015;386(10004):1659–1671. doi: 10.1016/S0140-6736(15)60169-6.
    1. Thompson T, Terhune DB, Oram C, Sharangparni J, Rouf R, Solmi M, Veronese N, Stubbs B. The effectiveness of hypnosis for pain relief: a systematic review and meta-analysis of 85 controlled experimental trials. Neurosci Biobehav Rev. 2019;99:298–310. doi: 10.1016/j.neubiorev.2019.02.013.
    1. Goffaux P, Redmond WJ, Rainville P, Marchand S. Descending analgesia--when the spine echoes what the brain expects. Pain. 2007;130(1–2):137–143. doi: 10.1016/j.pain.2006.11.011.
    1. Marchand S, Gaumond I. Effets placebo et nocebo dans le traitement de la douleur : leur présence est inévitable mais leurs actions sont modulables [Placebo and nocebo effects in pain treatment: their presence is inevitable but their action can be modulated] Douleur et Analgésie. 2014;27(4):198–202. doi: 10.1007/s11724-014-0403-y.
    1. Gandhi B, Oakley DA. Does 'hypnosis' by any other name smell as sweet? The efficacy of 'hypnotic' inductions depends on the label 'hypnosis'. Conscious Cogn. 2005;14(2):304–315. doi: 10.1016/j.concog.2004.12.004.
    1. Bowers KS, Brenneman HA. Hypnosis and the perception of time. Int J Clin Exp Hypn. 1979;27(1):29–41. doi: 10.1080/00207147908407540.
    1. Schwartz W. Time and context during hypnotic involvement. Int J Clin Exp Hypn. 1978;26(4):307–316. doi: 10.1080/00207147808411255.

Source: PubMed

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