The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study

Ravi R Bhatt,1 Sarah R Martin,1 Subhadra Evans,2 Kirsten Lung,1 Thomas D Coates,3,4 Lonnie K Zeltzer,1 Jennie C Tsao1 1UCLA Pediatric Pain and Palliative Care Program, Division of Hematology-Oncology, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2School of...

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Main Authors: Bhatt RR, Martin SR, Evans S, Lung K, Coates TD, Zeltzer LK, Tsao JC
Format: Article
Language:English
Published: Dove Medical Press 2017-07-01
Series:Journal of Pain Research
Subjects:
Online Access:https://www.dovepress.com/the-effect-of-hypnosis-on-pain-and-peripheral-blood-flow-in-sickle-cel-peer-reviewed-article-JPR
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author Bhatt RR
Martin SR
Evans S
Lung K
Coates TD
Zeltzer LK
Tsao JC
author_facet Bhatt RR
Martin SR
Evans S
Lung K
Coates TD
Zeltzer LK
Tsao JC
author_sort Bhatt RR
collection DOAJ
description Ravi R Bhatt,1 Sarah R Martin,1 Subhadra Evans,2 Kirsten Lung,1 Thomas D Coates,3,4 Lonnie K Zeltzer,1 Jennie C Tsao1 1UCLA Pediatric Pain and Palliative Care Program, Division of Hematology-Oncology, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2School of Psychology, Deakin University, Geelong, VIC, Australia; 3Department of Pediatrics, Keck School of Medicine, University of Southern California, 4Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA Background: Vaso-occlusive pain crises (VOCs) are the “hallmark” of sickle-cell disease (SCD) and can lead to sympathetic nervous system dysfunction. Increased sympathetic nervous system activation during VOCs and/or pain can result in vasoconstriction, which may increase the risk for subsequent VOCs and pain. Hypnosis is a neuromodulatory intervention that may attenuate vascular and pain responsiveness. Due to the lack of laboratory-controlled pain studies in patients with SCD and healthy controls, the specific effects of hypnosis on acute pain-associated vascular responses are unknown. The current study assessed the effects of hypnosis on peripheral blood flow, pain threshold, tolerance, and intensity in adults with and without SCD. Subjects and methods: Fourteen patients with SCD and 14 healthy controls were included. Participants underwent three laboratory pain tasks before and during a 30-minute hypnosis session. Peripheral blood flow, pain threshold, tolerance, and intensity before and during hypnosis were examined. Results: A single 30-minute hypnosis session decreased pain intensity by a moderate amount in patients with SCD. Pain threshold and tolerance increased following hypnosis in the control group, but not in patients with SCD. Patients with SCD exhibited lower baseline peripheral blood flow and a greater increase in blood flow following hypnosis than controls. Conclusion: Given that peripheral vasoconstriction plays a role in the development of VOC, current findings provide support for further laboratory and clinical investigations of the effects of cognitive–behavioral neuromodulatory interventions on pain responses and peripheral vascular flow in patients with SCD. Current results suggest that hypnosis may increase peripheral vasodilation during both the anticipation and experience of pain in patients with SCD. These findings indicate a need for further examination of the effects of hypnosis on pain and vascular responses utilizing a randomized controlled trial design. Further evidence may help determine unique effects of hypnosis and potential benefits of integrating cognitive–behavioral neuromodulatory interventions into SCD treatment. Keywords: sickle-cell disease, pain, hypnosis, blood
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spelling doaj.art-749a23cb7db84ae9a2bb672e2bf126282022-12-22T00:23:56ZengDove Medical PressJournal of Pain Research1178-70902017-07-01Volume 101635164433765The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot studyBhatt RRMartin SREvans SLung KCoates TDZeltzer LKTsao JCRavi R Bhatt,1 Sarah R Martin,1 Subhadra Evans,2 Kirsten Lung,1 Thomas D Coates,3,4 Lonnie K Zeltzer,1 Jennie C Tsao1 1UCLA Pediatric Pain and Palliative Care Program, Division of Hematology-Oncology, Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; 2School of Psychology, Deakin University, Geelong, VIC, Australia; 3Department of Pediatrics, Keck School of Medicine, University of Southern California, 4Children’s Center for Cancer and Blood Diseases, Children’s Hospital Los Angeles, Los Angeles, CA, USA Background: Vaso-occlusive pain crises (VOCs) are the “hallmark” of sickle-cell disease (SCD) and can lead to sympathetic nervous system dysfunction. Increased sympathetic nervous system activation during VOCs and/or pain can result in vasoconstriction, which may increase the risk for subsequent VOCs and pain. Hypnosis is a neuromodulatory intervention that may attenuate vascular and pain responsiveness. Due to the lack of laboratory-controlled pain studies in patients with SCD and healthy controls, the specific effects of hypnosis on acute pain-associated vascular responses are unknown. The current study assessed the effects of hypnosis on peripheral blood flow, pain threshold, tolerance, and intensity in adults with and without SCD. Subjects and methods: Fourteen patients with SCD and 14 healthy controls were included. Participants underwent three laboratory pain tasks before and during a 30-minute hypnosis session. Peripheral blood flow, pain threshold, tolerance, and intensity before and during hypnosis were examined. Results: A single 30-minute hypnosis session decreased pain intensity by a moderate amount in patients with SCD. Pain threshold and tolerance increased following hypnosis in the control group, but not in patients with SCD. Patients with SCD exhibited lower baseline peripheral blood flow and a greater increase in blood flow following hypnosis than controls. Conclusion: Given that peripheral vasoconstriction plays a role in the development of VOC, current findings provide support for further laboratory and clinical investigations of the effects of cognitive–behavioral neuromodulatory interventions on pain responses and peripheral vascular flow in patients with SCD. Current results suggest that hypnosis may increase peripheral vasodilation during both the anticipation and experience of pain in patients with SCD. These findings indicate a need for further examination of the effects of hypnosis on pain and vascular responses utilizing a randomized controlled trial design. Further evidence may help determine unique effects of hypnosis and potential benefits of integrating cognitive–behavioral neuromodulatory interventions into SCD treatment. Keywords: sickle-cell disease, pain, hypnosis, bloodhttps://www.dovepress.com/the-effect-of-hypnosis-on-pain-and-peripheral-blood-flow-in-sickle-cel-peer-reviewed-article-JPRsickle-cell diseasepainhypnosisblood
spellingShingle Bhatt RR
Martin SR
Evans S
Lung K
Coates TD
Zeltzer LK
Tsao JC
The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study
Journal of Pain Research
sickle-cell disease
pain
hypnosis
blood
title The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study
title_full The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study
title_fullStr The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study
title_full_unstemmed The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study
title_short The effect of hypnosis on pain and peripheral blood flow in sickle-cell disease: a pilot study
title_sort effect of hypnosis on pain and peripheral blood flow in sickle cell disease a pilot study
topic sickle-cell disease
pain
hypnosis
blood
url https://www.dovepress.com/the-effect-of-hypnosis-on-pain-and-peripheral-blood-flow-in-sickle-cel-peer-reviewed-article-JPR
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