Abstract Archives of the RSNA, 2006


SSM01-04

Adjunctive Self-hypnotic Relaxation during Image-guided Large Core Needle Biopsy of the Breast: A Prospective Randomized Trial

Scientific Papers

Presented on November 29, 2006
Presented as part of SSM01: Breast Imaging (Interventional)

Participants

Elvira Valentina Lang MD, Presenter: Nothing to Disclose
Kevin Staley Berbaum PhD, Abstract Co-Author: Nothing to Disclose
Salomao Faintuch MD, Abstract Co-Author: Nothing to Disclose
Olga Catrina Hatsiopoulou MD, Abstract Co-Author: Nothing to Disclose
Michael Berbaum PhD, Abstract Co-Author: Nothing to Disclose
Janet K. Baum MD, Abstract Co-Author: Consultant, iCAD, Inc
Xinyu Li MS, Abstract Co-Author: Nothing to Disclose
Eleanor D. Laser PhD, Abstract Co-Author: Nothing to Disclose
Noami Halsey, Abstract Co-Author: Nothing to Disclose
et al, Abstract Co-Author: Nothing to Disclose

PURPOSE

To assess whether adjunct self-hypnotic relaxation reduces pain and anxiety during image-guided large core needle biopsy of the breast (LCNB).

METHOD AND MATERIALS

236 women referred for LCNB to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during LCNB. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0-10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, compared in an ordinal logistic regression model.

RESULTS

Women presented with elevated anxiety. Anxiety increased further significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = –0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = –0.27, p < 0.001). Anxiety increased more with standard care than empathy and hypnosis and decreased more with hypnosis than empathy (all p < 0.01). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional provider: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis.

CONCLUSION

While both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost.

CLINICAL RELEVANCE/APPLICATION

Self hypnotic relaxation offers patients during large core needle breast biopsy a drug free choice for reducing pain and anxiety without adding procedure time, cost, or side effects.

Cite This Abstract

Lang, E, Berbaum, K, Faintuch, S, Hatsiopoulou, O, Berbaum, M, Baum, J, Li, X, Laser, E, Halsey, N, et al, , Adjunctive Self-hypnotic Relaxation during Image-guided Large Core Needle Biopsy of the Breast: A Prospective Randomized Trial.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4427198.html