Hypnosis for burn wound care pain and anxiety: A systematic review and meta-analysis

Background: Evidence from clinical trials suggests psychological interventions should be considered as an adjunct to medications. Objective: The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of clinical hypnosis on pain, anxiety and medication needs during wound care in adults suffering from a burn injury. Data sources: Medline, PsychINFO, CINAHL, Embase, ISI, SCOPUS, Cochrane, and Proquest databases were searched for randomized controlled trials comparing hypnosis to other interventions during dressing change in adult patients. Data synthesis: Two independent reviewers extracted relevant articles and assessed their methodological quality. Only six studies met the inclusion criteria and were described in detail. Available data was pooled with Revman 5.3. Results: For the primary outcome, we found a statistically significant difference in pain intensity ratings favoring hypnosis (MD= -8.90, 95% CI -16.28, -1.52). For the secondary outcomes, there was a statistically significant difference in anxiety ratings favoring hypnosis (MD= -21.78, 95% CI -35.64, -7.93) and no difference in medication usage (MD= -0.07, 95% CI -0.32, 0.17). Conclusion: These results suggest that hypnosis reduces pain intensity and anxiety ratings in adults undergoing burn wound care. However, because of the limitations discussed, clinical recommendations are still premature. (C) 2018 Elsevier Ltd and ISBI. All rights reserved.