Bone Marrow Biopsy Clinical Trial
QUALHYBOM : Hypnosis Versus Equimolar Mixture of Oxygen and Nitrous Oxide (MEOPA) During a Bone Marrow Biopsy
The Osteo-Medullary Biopsy (BOM) is a procedure performed by means of a trocar and makes it possible to obtain a bone core. This gesture is usually performed by performing local subcutaneous anesthesia at the puncture site of the postero-superior iliac crest. Patient comfort is improved by the concomitant use during the examination of mouthpiece inhalation of gas in the form of Equimolar Mixture of Oxygen and Nitrous Oxide (MEOPA). Despite these analgesia precautions, this biopsy procedure causes acute pain at the puncture site, which is only partially relieved. Performing BOM under hypnosis represents an alternative that can provide additional comfort to the patient through better tolerance and reduced pain perception, compared to MEOPA. During hypnosis, stimulation of sleeping and awake cortical areas has been shown to reduce the pain experienced by the patient. Thanks to a retrospective study carried out in the hematology service of the Rennes University Hospital, we observed a net benefit of hypnosis on the comfort and pain felt during the realization of a bone marrow biopsy, associated with a decrease in anxiety, and this in the absence of use of MEOPA. In addition, the number of cubicles obtained during the examination (proportional to the size of the biopsy core) was better. Obtaining more than 10 stalls (figure required by pathologists for a quality examination) was observed in 78% of cases with hypnosis versus 53% with Equimolar Mixture of Oxygen and Nitrous Oxide (MEOPA). Lastly, the doctor taking the sample reported better operational comfort when accompanied by the nurse hypnotherapist.
This original project aims, on the one hand, to improve the conditions for carrying out a procedure known to be invasive and painful and, on the other hand, to ensure better quality. So far, only one randomized study has been reported on the use of hypnosis in adults during a bone marrow biopsy showing a significant improvement in the anxiety generated by this test. ;