BACKGROUND Clinicians traditionally warn patients of pain before peripheral i.v. cannulation (PIVC). However, using words related to pain or undesirable experiences can result in greater pain and anxiety. The use of positive words can improve pain perception and subjective patient experience. We aimed to compare the effects of three types of communication, including hypnotic communication, on pain, comfort, and anxiety in patients during PIVC. METHODS The Effect of Language and Confusion on Pain During Peripheral Intravenous Catheterization (KTHYPE) trial is a randomised, parallel, single-blind, multicentre study of patients undergoing PIVC on the dorsal face of the hand before surgery. Patients from three hospitals were randomly allocated to one of three groups: PIVC performed with a hypnosis technique (hypnosis group), negative connotation (nocebo group), and neutral connotation (neutral group). The primary outcome measure was the occurrence of pain measured with a 0-10 numerical rating scale just after PIVC. RESULTS Of the 272 subjects analysed (hypnosis, n=89; nocebo, n=92; neutral, n=91), pain after PIVC was lower in the hypnosis group (mean [standard deviation]; range) (1.5 [1.9]; 0-5) compared with the neutral (3.5 [2.3]; 0-9; P<0.0001) and nocebo groups (3.8 [2.5]; 0-10; P<0.0001). Whilst anxiety was higher and comfort lower before PIVC in the hypnosis group, anxiety decreased and comfort perception increased after PIVC when hypnosis was used. CONCLUSIONS This is one of the first well-designed RCTs showing a significant benefit of a hypnosis technique during a routine procedure, such as PIVC. The results could facilitate implementation of hypnosis in daily clinical care. CLINICAL TRIAL REGISTRATION NCT02662322.

中文翻译：

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催眠和沟通可减轻周围静脉插管的疼痛和焦虑：语言和意识混乱对外周静脉导管插入术（KTHYPE）期间疼痛的影响，一项多中心随机试验。

背景技术传统上，临床医生会在外周静脉插管（PIVC）之前警告患者疼痛。但是，使用与疼痛或不良经历相关的词语可能会导致更大的疼痛和焦虑。使用肯定词可以改善疼痛感和主观患者体验。我们旨在比较包括催眠性交流在内的三种交流方式对PIVC患者的疼痛，舒适度和焦虑的影响。方法言语和困惑对外周静脉导管插入术（KTHYPE）期间疼痛的影响是一项随机，平行，单盲，多中心研究，研究对象是术前在手背侧进行PIVC的患者。来自三家医院的患者被随机分配到三组之一：采用催眠技术进行的PIVC（催眠组），否定含义（nocebo组）和中性含义（中性组）。主要结果指标是紧接PIVC后使用0-10数字评分量表测量的疼痛发生率。结果在分析的272名受试者中（催眠，n = 89； nocebo，n = 92；中性，n = 91），催眠组的PIVC疼痛较轻（平均[标准偏差]；范围）（1.5 [1.9]；平均[标准差]）。 0-5）与中性（3.5 [2.3]; 0-9; P <0.0001）和Nocebo组（3.8 [2.5]; 0-10; P <0.0001）进行比较。催眠组在PIVC之前焦虑较高，舒适感较低，而在使用催眠剂的PIVC后，焦虑降低且舒适感增强。结论这是首批设计良好的RCT之一，在常规程序（例如PIVC）中显示出催眠技术的显着优势。结果可以促进催眠在日常临床护理中的实施。临床试验注册NCT02662322。