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Hypnosedation for endocavitary uterovaginal applications: A pilot study.

Authors :
Kissel, Manon
Andraud, Mickaël
Duhamel, Anne-Sophie
Boulle, Geoffroy
Romano, Edouard
Achkar, Samir
Bourdais, Rémi
Ta, Minh-Hanh
Pounou, Arthur
Kumar, Tamizhanban
Celestin, Bernard
Bordenave, Lauriane
Billard, Valérie
Haie-Meder, Christine
Chargari, Cyrus
Source :
Brachytherapy. Jul2020, Vol. 19 Issue 4, p462-469. 8p.
Publication Year :
2020

Abstract

Implantations for uterovaginal brachytherapy are usually performed under general or spinal anesthesia, which are not without risk. As it is a rather short procedure and since postoperative pain is minimal, hypnosedation was proposed to selected patients requiring endocavitary applications as part of their routine treatment. Consecutive patients requiring intracavitary uterovaginal brachytherapy from January to October 2019 were included if they accepted the procedure. A premedication was systematically administered. Hypnosedation was based on an Ericksonian technique. The procedure was immediately interrupted if the patient requested it, in cases of extreme anxiety or pain. Procedure was in that case rescheduled with a "classical" anesthesia technique. A total of 20 patients were included. Four patients had to be converted toward a general anesthesia: one because of a fibroma on the probe's way and three young patients with a very anteverted/retroverted uterus that was painful at every mobilization. Mean and maximum pain scores during implant were 2.9/10 and 5.1/10, respectively. The most painful maneuver was cervical dilation for 45% of the patients, followed by mold insertion in 40% of cases. About 85% of the patients declared that hypnosis helped them relax; 90% of the patients would recommend the technique. No procedure-related complication occurred. With a 70% success rate (correct implant with mean pain and anxiety scores < 5), one can conclude that uterovaginal brachytherapy implantation under hypnosedation is feasible and received a high satisfaction rate from the patients. This technique may reduce overall treatment time in a context of difficult access to the OR and to anesthesiologists, while reducing anesthetic drugs resort and postoperative nausea. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
15384721
Volume :
19
Issue :
4
Database :
Academic Search Index
Journal :
Brachytherapy
Publication Type :
Academic Journal
Accession number :
144547826
Full Text :
https://doi.org/10.1016/j.brachy.2020.03.008