Procedural Pain Management by Multimodal Sedation Analgesia Combining Hypnosis in Children With Congenital Heart Disease

NCT ID: NCT06373627

Last Updated: 2024-04-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

104 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-05-02

Study Completion Date

2025-05-03

Brief Summary

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The aim of this prospective randomized controlled trial is to evaluate therapeutic hypnosis as a co-analgesia in thoracic drain removal in children with congenital heart disease. The hypothesis of this study is that therapeutic hypnosis combined with a minimal effective dose of medicated and inhaled sedation-analgesia is not inferior to higher doses of sedation-analgesia usually employed. This would make possible the reduction of cumulative dose of sedative medication and their side effects.

Detailed Description

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Pain and anxiety are common in children with congenital heart disease. They are at risk to develop impaired pain signal processing, and tolerance to opioids and benzodiazepines due to repeated exposure.

Removal of thoracic drains is a standard procedure following cardiac surgery in patients with congenital heart disease. This procedure is usually performed after multimodal sedation-analgesia (intraveinous and inhalation drugs). However, the drugs used (ketamine and midazolam) can have significant side-effects, such as respiratory and circulatory depression.

A few studies have shown the efficacy of therapeutic hypnosis and distractive methods in children, but with a low level of evidence, unlike in adults.

However, none of these studies has evaluated therapeutic hypnosis in children with congenital heart disease.

Hypnosis would be an additional way of better controlling procedural pain, without the side effects of medication. This would reduce the dose of analgesic drugs and improve the pain experience.

The aim of PEACE-Hypno is to evaluate therapeutic hypnosis as a co-analgesic way of thoracic drain removal in children with congenital heart disease.

Conditions

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Procedural Pain Congenital Heart Disease Heart Surgery Hypnosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Hypnosis

Hypnosis + MEOPA + direct intravenous Ketamine (0.3 mg/kg) In the event of insufficient analgesia or failure of hypnosis, a 2nd dose of ketamine (0.3 mg/kg) may be administered.

Group Type EXPERIMENTAL

Hypnosis

Intervention Type OTHER

A hypnosis session takes place in 3 stages:

* An induction stage, where we move from an ordinary state of consciousness to a modified state of consciousness through dissociation.
* A work phase to deepen the hypnotic trance. This phase is fueled by the construction of suggestions and metaphors, analogous to those of the patient in pain.
* Finally, a return to the ordinary state of consciousness through re-association with the patient.

Medications used in addition to hypnosis

Intervention Type DRUG

MEOPA + intravenous ketamine (0.3 mg/kg)

Conventional sedation-analgesia

MEOPA + direct intravenous Ketamine (0.5 mg/kg) + direct intravenous Midazolam (50 µg/kg) In accordance with current service protocol.

Group Type ACTIVE_COMPARATOR

Conventional medications used for sedation-analgesia

Intervention Type DRUG

MEOPA + intravenous ketamine (0.5 mg/kg) + intraveinous midazolam (50µg/kg)

Interventions

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Hypnosis

A hypnosis session takes place in 3 stages:

* An induction stage, where we move from an ordinary state of consciousness to a modified state of consciousness through dissociation.
* A work phase to deepen the hypnotic trance. This phase is fueled by the construction of suggestions and metaphors, analogous to those of the patient in pain.
* Finally, a return to the ordinary state of consciousness through re-association with the patient.

Intervention Type OTHER

Conventional medications used for sedation-analgesia

MEOPA + intravenous ketamine (0.5 mg/kg) + intraveinous midazolam (50µg/kg)

Intervention Type DRUG

Medications used in addition to hypnosis

MEOPA + intravenous ketamine (0.3 mg/kg)

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Patients aged ⩾ 6 years and \<18 years.
* Postoperative cardiac surgery patients with intrathoracic drains (pleural or mediastinal).
* Patients affiliated with or benefiting from a social security or similar scheme.
* Oral consent obtained from minor children
* Written consent from the minor's legal representatives

Exclusion Criteria

* Psychomotor retardation, cognitive/psychiatric impairment preventing self-assessment of pain
* Absence of at least 1 legal representative of the minor child
* French not understood
Minimum Eligible Age

6 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondation Hôpital Saint-Joseph

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Edouard CHAMBON

Role: PRINCIPAL_INVESTIGATOR

Fondation Hôpital Saint-Joseph

Central Contacts

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Marie GERARD

Role: CONTACT

0672510756

Sébastien HASCOËT

Role: CONTACT

0140942429

References

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Other Identifiers

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2024-A00534-43

Identifier Type: -

Identifier Source: org_study_id

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