Standard of care versus standard of care plus Ericksonian hypnosis for percutaneous liver biopsy: Results of a randomized control trial

Purpose: The purpose of this study was to compare levels of pain and anxiety during percutaneous ultrasoundguided liver biopsy between patients receiving standard of care and those receiving standard of care plus the support of Ericksonian hypnosis. Materials and methods: This prospective, single-center, single-blind, randomized controlled superiority trial included 70 participants. Participants were randomly assigned to either the standard of care group and received oral anxiolytic medications with reassuring conversational support, or to the experimental group, and received Ericksonian hypnosis (i.e., conversational hypnosis) in addition to standard of care. The primary outcome was the level of pain experienced during the biopsy, measured on a 10-point visual analog scale (0 indicating no pain to 10 indicating excruciating pain). Secondary outcomes included anxiety level during the biopsy, pain level within one hour of the biopsy measured using the same 10-point visual analog scale, amount of analgesic medication taken in the 24 h following the biopsy, and patient willingness to undergo another ultrasound-guided percutaneous liver biopsy in the future. Results: Thirty-six participants were included in the standard of care group, and 34 were included in the experimental group. The mean score of pain experienced during the biopsy was lower in the experimental group (2.4 f 1.9 [standard deviation (SD)]) compared to the standard of care group (4.4 f 2.6 [SD]) (P = 0.001). The level of anxiety experienced during the biopsy was lower in the hypnosis group (2.1 f 1.8 [SD]) compared to the standard of care group (4.8 f 2.4 [SD]) (P < 0.001). No significant differences in other secondary outcomes were observed between the two groups. Conclusion: The addition of Ericksonian hypnosis to standard of care reduces the pain experienced by patients during percutaneous ultrasound-guided percutaneous liver biopsy by comparison with standard of care alone.