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The Anxiolytic Effect of Hypnosis in Colonoscopy and Sigmoidoscopy

The Anxiolytic Effect of Hypnosis in Colonoscopy and Sigmoidoscopy. Ming Ho, Eamonn Coveney BSCAH National Conference 8 th May 2019 Education Centre, West Suffolk Hospital, Bury St Edmunds. Aim.

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The Anxiolytic Effect of Hypnosis in Colonoscopy and Sigmoidoscopy

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  1. The Anxiolytic Effect of Hypnosis in Colonoscopy and Sigmoidoscopy Ming Ho, EamonnCoveney BSCAH National Conference 8th May 2019 Education Centre, West Suffolk Hospital, Bury St Edmunds

  2. Aim • To examine the anxiolytic and analgesic effect of hypnosis during colonoscopy and sigmoidoscopy • To explore the quality of colonoscopy performed with hypnosis by comparing its adenoma detection rate (ADR) to the UK national standard

  3. Methods • Patients recruited from February to July 2018 • Patients were offered hypnosis with or without sedation • Evaluation: • a peri-operative discomfort (10-point score, visual analogue scales) from the patients • a nurse reported discomfort score • the amount of sedation used • The detection of an adenoma was recorded from histology reports. • Anxiety score was also recorded in the hypnosis group before hypnotic intervention and in the endoscopy suite • Analyses were performed with two means t test and proportions z score

  4. Results • 66 endoscopies • 35 (53%) with hypnosis • Average time 3 minutes and 37 seconds • There were no significant differences in demographics between the hypnosis group and the non-hypnosis group • Overall, no significant differences in • patient reported discomfort (5.2 versus 4.2, p=0.13) • nurse reported discomfort score (2.2 versus 2.0, p=0.56) • the amount of sedation used (1.7mg versus 1.9mg of Midazolam, p=0.74) • the ADR between the two groups (28% versus 35%, p=0.35) • A significant reduction in the anxiety score reported by patients in the hypnosis group (65 versus 35, p<0.001)

  5. Conclusion • A very brief hypnotic intervention prior to colonoscopy or sigmoidoscopy provided no additional analgesic benefit • However, it produced a significant reduction in anxiety scores in patients undergoing the procedure • Hypnosis did not seem to compromise the quality of endoscopy • Hypnosis may hold potential benefits for patients undergoing lower gastrointestinal endoscopy

  6. Key to ‘success’ • Good communication • Inform the in charge • Through debrief with team • Through discussion with patients • Good team • Understood what is happening and helping out • Good time keeping • Or you may not get the next chance!

  7. Challenges • Time limitation • 4 minutes script max (Still under time pressure) • Difficult in patient selection • Pre-assessment of suggestibility was not possible • Though you may get special referrals – multiple failed scopes

  8. My experience in hypnosis • Fairly limited as you see • Helped by great inspirations • Just try it (non-maleficent and beware of contraindications) • Very rewarding when it works • Good to have another tool

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