Effect of hypnotic communication on pain during arterial blood gas standardized procedures in the emergency department compared with traditional communication: a triple-blind randomized controlled trial (POPAIN study)
Abstract
Background and importance Although various strategies have been examined to mitigate discomfort during sampling, arterial blood gas (ABG) is a common and often painful procedure in emergency departments (EDs). Hypnotic communication, characterized by positive language/suggestions, may help reduce perceived procedural pain. Conversely, the traditional use of negative language may increase discomfort through a ‘nocebo’ effect. Objective To assess whether hypnotic communication reduces procedural pain during ABG sampling compared with neutral or nocebo communication, when delivered by emergency physicians who have not received training in hypnosis. Design, setting, and participants A single-center, triple-blind, randomized controlled trial with three parallel arms (hypnotic, neutral, and nocebo) was conducted from 4 April 2023 to 31 July 2024, in the ED of a Swiss Tertiary Care Hospital. All adult patients requiring ABG sampling were eligible for inclusion. Intervention Three standardized communication scripts were used during a standardized procedure for ABG sampling: nocebo with negative words (e.g. ‘I’m going to prick’), neutral with neutral words (e.g. ‘I am taking the sample’), and hypnotic with positive words, and dissociative sentences (e.g. ‘What is the noise of the lights at your home?’). Communications were audio-recorded and independently reviewed to ensure protocol adherence. Outcomes measure and analysis The primary outcome was the pain intensity, measured with a…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 216 participants or records.
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