Efficacy of a combination of hypnosis and transcutaneous electrical nerve stimulation for chronic non-cancer pain: A randomized controlled trial.
Louise Tonye-Geoffroy, Stéphanie Mauboussin Carlos, Sophie Tuffet and 4 others
PMID 33783846WHAT IT FOUND
Adding nurse-delivered hypnosis to TENS did not reduce chronic non-cancer pain more than TENS alone at three months.
Both groups had similar pain reduction.
Key findings
01The primary outcome was null: mean VAS change from day 0 to month 3 was −23.6 mm with TENS alone and −22.6 mm with TENS plus hypnosis (p = .85).
02Pain intensity decreased in both groups from day 0 to month 3 while patients continued usual medical treatment, with mean VAS score variation of 40.2% and 40.0%.
03At month 3, no significant differences were found for SF-36 mental (p = .43) and physical (p = .25) scores, compliance (p = .33), analgesic consumption (p = .38) or PGIC (p = .69).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Patients and nurses could not be blinded to allocation because of the nature of the intervention. The trial was performed in a single centre, limiting external validity. Two control patients were excluded after randomisation, and 70 patients were analysed. Missing primary outcome values were imputed using last observation carried forward. Patients continued usual medical treatment, so pain reduction cannot be attributed to TENS or hypnosis alone. Analgesic intake and home TENS sessions were declarative rather than objectively measured. VAS pain scores may not be able to detect changes over a three-month period in complex chronic pain. PGIC was exploratory and a validated French PGIC scale is not available. Hypnotisability was not evaluated. Anxiety and depression were not specifically evaluated, although they may modify outcome.
Declared interests
No conflicts of interest were declared. The sponsor was Assistance Publique - Hôpitaux de Paris, and funding was Programme Hospitalier de Recherche Infirmière et Paramédicale 2012 (Ministère de la Santé, No. PHRI120049).
The easy way to misread this
Do not read the similar pain reduction in both groups as proof that hypnosis adds benefit. The primary between-group comparison was null, and both groups received TENS while continuing usual medical treatment.