Self-Hypnosis for the Enhanced Recovery After Surgery in Patients with Gynecologic Cancer

Not Applicable

Active, not recruiting

• Conditions: Metastatic Cervical Cancer; Malignant Female Reproductive System Neoplasm; Recurrent Malignant Female Reproductive System Neoplasm
• Interventions: Other: Best Practice; Procedure: Hypnotherapy; Other: Questionnaire Administration; Other: Quality-of-Life Assessment

• Registration Number: NCT04266886
• Lead Sponsor: M.D. Anderson Cancer Center

Brief Summary

This trial studies how well self-hypnosis works in enhancing recovery after surgery in patients with gynecologic cancer. A guided relaxation method called self-hypnosis may help affect how patients feel pain and symptoms after surgery.

Detailed Description

PRIMARY OBJECTIVE:

I. To evaluate whether participation in pre-operative self-hypnosis (SH) is feasible and will improve patients' perception of post-surgical pain, after undergoing open gynecologic surgery (laparotomy) on an enhanced recovery pathway.

SECONDARY OBJECTIVES:

I. To evaluate whether participation in pre-operative SH is associated with changes in use of opioid medication, including time to first postoperative opioid and total dose of opioids taken (converted to morphine equivalents) and avoidance of opioids.

II. To explore whether participation in pre-operative SH is associated with changes in length of stay.

III. To explore whether there are differences between the two study arms in other common symptoms of women undergoing gynecologic surgery, functional recovery after surgery and quality of life (QOL).

IV. To explore whether expectations regarding symptom management or hypnotic susceptibility are related to or influence the perception of symptoms after surgery.

V. To measure satisfaction with the intervention (patients on arm 2). VI. To perform sub analyses to explore whether other common clinical or demographic factors are potential covariates.

EXPLORATORY OBJECTIVE:

I. To compare two different instruments measuring patient reported outcomes in hospital postoperative recovery.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients receive usual care including receipt of multi-modal analgesia and the injection of a local analgesic at the time of surgery on the enhanced recovery after surgery (ERAS) pathway.

ARM II: Patients receive usual care as in Arm I. Patients also receive self-hypnosis guided relaxation by listening to MP3 on the ERAS pathway.

Study Timeline

• Study Start: 2018-09-11
• Study First Submitted: 2019-12-30
• Study First Submitted QC: 2020-02-10
• Study First Posted: 2020-02-12
• Status Verified: 2024-09
• Last Update Submitted: 2024-09-27
• Last Update Posted: 2024-10-01
• Primary Completion: 2024-12-31
• Study Completion: 2024-12-31

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: Female
• Target Recruitment: 152

Inclusion Criteria

• Undergoing an exploratory laparotomy for suspected gynecologic cancer, which includes metastatic disease from neoplasia originating in other organs
• Planned participation in the Gynecologic Enhanced Recovery Pathway
• Patient must be able to read, understand, and speak English
• Consents to being part of a randomized study
• Patient has physical and mental capabilities to take part in study

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Exclusion Criteria

• Sensitivity to amide-type local anesthetics
• Patients on long-acting opioid medications, or scheduled (four or more times a day for seven or more days) short-acting opioid medications within the last 30 days
• Emergency surgery of any type that does not allow for proper time for protocol review by the patient
• Surgery that involves known/anticipated resection of anterior abdominal wall with plastic surgery reconstruction
• Patients undergoing known/anticipated anterior abdominal wall hernia repairs
• Patients undergoing pelvic exenteration
• Patients with known major psychiatric disease
• Patients with hearing impairment such that they are unable to hear the intervention

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Arm I (usual care)	Best Practice	Patients receive usual care including receipt of multi-modal analgesia and the injection of a local analgesic at the time of surgery on the ERAS pathway.
Arm I (usual care)	Questionnaire Administration	Patients receive usual care including receipt of multi-modal analgesia and the injection of a local analgesic at the time of surgery on the ERAS pathway.
Arm II (usual care, self-hypnosis guided relaxation)	Quality-of-Life Assessment	Patients receive usual care as in Arm I. Patients also receive self-hypnosis guided relaxation by listening to MP3 on the ERAS pathway.
Arm II (usual care, self-hypnosis guided relaxation)	Hypnotherapy	Patients receive usual care as in Arm I. Patients also receive self-hypnosis guided relaxation by listening to MP3 on the ERAS pathway.
Arm II (usual care, self-hypnosis guided relaxation)	Questionnaire Administration	Patients receive usual care as in Arm I. Patients also receive self-hypnosis guided relaxation by listening to MP3 on the ERAS pathway.
Arm I (usual care)	Quality-of-Life Assessment	Patients receive usual care including receipt of multi-modal analgesia and the injection of a local analgesic at the time of surgery on the ERAS pathway.
Arm II (usual care, self-hypnosis guided relaxation)	Best Practice	Patients receive usual care as in Arm I. Patients also receive self-hypnosis guided relaxation by listening to MP3 on the ERAS pathway.

Primary Outcome Measures

Name	Time	Method
Feasibility of participating in pre-operative self-hypnosis	Up to 1 day	Will assess proportion of participants who listen to the complete audio file in the preoperative holding area.
Patients' perception of post-surgical pain	Post-operative day 1 (POD1)	Will summarize POD1 pain scores for each treatment arm using descriptive statistics. Will use a Wilcoxon rank sums test to determine if the POD1 pain scores in the self-hypnosis arm are lower than the usual care arm. Pain intensity score from 0 to 10.

Trial Locations

Locations (1)

M D Anderson Cancer Center; 🇺🇸 Houston, Texas, United States