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Hypnotic communication cuts post-ABG pain intensity beta = -0.97 in ED patientsHypnotic words failed to reduce pain during blood draws in this emergency trial

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Key Takeaway
Consider that hypnotic communication reduced post-ABG pain statistically but not clinically in this ED trial.

This randomized controlled trial enrolled 216 adult patients requiring arterial blood gas sampling in the emergency department of a Swiss tertiary care hospital. The intervention was hypnotic communication, defined as positive language and dissociative sentences, compared with neutral communication and nocebo communication with negative words. The primary outcome was pain intensity measured on a 0 to 10 numerical rating scale 3 minutes after the procedure.

The main result showed hypnotic communication was associated with a statistically significant reduction in postprocedural pain compared with neutral communication, with an effect size of beta = -0.97 (95% CI: -1.80 to 0.14; P = 0.02). Median pain scores were nocebo: 3 (1-5), neutral: 4 (2-6), and hypnotic: 3 (1-5), with no significant differences among the three groups. No significant differences were observed among the groups for comfort or anxiety levels.

Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, were not reported. Key limitations include the lack of reported follow-up and the absence of clinically meaningful reductions in pain, anxiety, or discomfort despite the statistical finding. Practice relevance is restrained, as implementing hypnotic communication in the ED during ABG procedures did not lead to clinically meaningful improvements.

Pain during blood tests is a real problem for many patients. A team in a Swiss emergency department tested if special words could help. They used positive suggestions and calming phrases during arterial blood gas sampling. This is a procedure where a needle goes into an artery to check blood levels. The goal was to make the moment less scary and hurtful.

The study involved 216 adult patients. Some heard positive language, others heard neutral words, and a third group heard negative words meant to cause discomfort. The team measured pain levels just three minutes after the needle was removed. They also checked how comfortable patients felt and how anxious they were.

The results were mixed. While the positive words showed a statistical drop in pain scores on paper, the actual difference was tiny. When looking at the middle scores from the groups, there was no clear winner. Patients did not feel more comfortable or less anxious with the special words. The study notes that these small statistical changes did not mean a real improvement for the people involved.

No safety issues arose from the conversation techniques. The trial shows that simply changing the words used during a blood draw does not solve the problem of pain or fear in the emergency room.

What this means for you:
Special positive words did not meaningfully reduce pain or anxiety during blood draws in this trial.

Study Details

Study typeRct
Sample sizen = 216
EvidenceLevel 2
Follow-up864.0 mo
PublishedJun 2026
View Original Abstract ↓
BACKGROUND AND IMPORTANCE: Although various strategies have been examined to mitigate discomfort during sampling, arterial blood gas (ABG) is a common and often painful procedure in emergency departments (EDs). Hypnotic communication, characterized by positive language/suggestions, may help reduce perceived procedural pain. Conversely, the traditional use of negative language may increase discomfort through a 'nocebo' effect. OBJECTIVE: To assess whether hypnotic communication reduces procedural pain during ABG sampling compared with neutral or nocebo communication, when delivered by emergency physicians who have not received training in hypnosis. DESIGN, SETTING, AND PARTICIPANTS: A single-center, triple-blind, randomized controlled trial with three parallel arms (hypnotic, neutral, and nocebo) was conducted from 4 April 2023 to 31 July 2024, in the ED of a Swiss Tertiary Care Hospital. All adult patients requiring ABG sampling were eligible for inclusion. INTERVENTION: Three standardized communication scripts were used during a standardized procedure for ABG sampling: nocebo with negative words (e.g. ' I'm going to prick '), neutral with neutral words (e.g. ' I am taking the sample '), and hypnotic with positive words, and dissociative sentences (e.g. ' What is the noise of the lights at your home?' ). Communications were audio-recorded and independently reviewed to ensure protocol adherence. OUTCOMES MEASURE AND ANALYSIS: The primary outcome was the pain intensity, measured with a 0-10 numerical rating scale 3 min after the ABG sampling. Secondary outcomes included comfort and anxiety levels. Linear mixed-effects models were employed to conduct both intention-to-treat and per-protocol analyses. MAIN RESULTS: A total of 216 participants (median age 72 years; 57% male) were included (hypnotic, n  = 71; nocebo, n  = 71; neutral, n  = 74). Dyspnea was the leading reason for ED consultation ( n  = 143; 66.2%). Hypnotic communication was associated with a statistically significant reduction in postprocedural pain compared with neutral communication [ β = -0.97, 95% confidence interval (CI): -1.80 to 0.14, P  = 0.02]; however, no significant differences were observed among the three groups in terms of median (interquartile range) pain scores [nocebo: 3 (1-5), neutral: 4 (2-6), hypnotic: 3 (1-5)], comfort or anxiety levels. CONCLUSION: Implementing hypnotic communication in the ED during ABG procedures did not lead to clinically meaningful reductions in pain, anxiety, or discomfort.
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