Nonpharmacologic analgesia and anxiolysis for interventional radiological procedures

Conventional pain management with drugs has limitations and potentially ser ious side effects. Use of structured empathic attention and self-hypnosis c an effectively reduce patients' pain perception and anxiety during interven tional procedures, with the effect becoming more pronounced the longer a pr ocedure lasts. Both nonpharmacologic interventions result in use of less se datives and narcotics during procedures and fewer episodes of respiratory d epression. However, in a prospective randomized study, only patients who ha d self-hypnosis had also fewer incidents of hemodynamic instability. Applie d correctly and according to a written set of instructions, nonpharmacologi c analgesia intervention can shorten total room time significantly, resulti ng in savings of precious resources. The techniques presented have been str uctured so that they are relatively immune to interruptions and can be appl ied safely in the procedure suite. Techniques include establishing of rappo rt by adapting verbal and nonverbal communication patterns to the patients' preferred mode, use of positive suggestions, avoidance of negatively loade d suggestions, and rapid induction of hypnosis where patients concentrate o n a sensation of floating in a safe and comfortable place. With this approa ch, average, nonselected patients can easily engage in an imagery process r egardless of their hypnotic potential.