Semin intervent Radiol 1999; 16(2): 113-123
DOI: 10.1055/s-0028-1082196
Copyright © 1999 by Thieme Medical Publishers, Inc.

Nonpharmacologic Analgesia and Anxiolysis for Interventional Radiological Procedures

Elvira V. Lang* , Susan Lutgendorf , Henrietta Logan , Eric G. Benotsch§ , Eleanor Laser , David Spiegel¶¶
  • *Department of Radiology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts
  • †Department of Psychology, and
  • ‡Department of Community and Preventive Dentistry, Department of Radiology, University of Iowa, Iowa City, Iowa
  • §Department of Psychology, Institute for AIDS Research, Wisconsin College of Medicine, Milwaukee, Wisconsin
  • ¶ and
  • ¶¶Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
Further Information

Publication History

Publication Date:
12 September 2008 (online)

Abstract

Conventional pain management with drugs has limitations and potentially serious side effects. Use of structured empathic attention and self-hypnosis can effectively reduce patients' pain perception and anxiety during interventional procedures, with the effect becoming more pronounced the longer a procedure lasts. Both nonpharmacologic interventions result in use of less sedatives and narcotics during procedures and fewer episodes of respiratory depression. However, in a prospective randomized study, only patients who had self-hypnosis had also fewer incidents of hemodynamic instability. Applied correctly and according to a written set of instructions, nonpharmacologic analgesia intervention can shorten total room time significantly, resulting in savings of precious resources. The techniques presented have been structured so that they are relatively immune to interruptions and can be applied safely in the procedure suite. Techniques include establishing of rapport by adapting verbal and nonverbal communication patterns to the patients' preferred mode, use of positive suggestions, avoidance of negatively loaded suggestions, and rapid induction of hypnosis where patients concentrate on a sensation of floating in a safe and comfortable place. With this approach, average, nonselected patients can easily engage in an imagery process regardless of their hypnotic potential.