Clinical Trial Summary
Tracheotomy is requested when upper aero-digestive tracts are obstructed. This obstruction
can have a tumour, infectious, inflammatory, traumatic or nervous origin. Most tracheotomy
surgeries are performed for tumour-induced obstruction. Tracheotomy allows the setting of a
respiratory flux thanks to a cannula and excludes the upper airways. The cannula is washed
every day from once to several times depending on the patient's secretions production and it
is usually replaced every week. The second replacement takes place about 10 days after
surgery. Patient education takes place at every replacement in order to empower him/her and
in consequence to increase living comfort. This empowerment is achieved at the 4th or 5th
replacement, at best. Because of the risks and complications related to tracheotomy and
because of the concerned vital function, the cannula replacement leads to anxiety especially
during the first replacements. Usual patient's anxiety management consists in reassuring the
patient during the replacement. In other situations, patients' anxiety management would be
drugs, however due to sedative and anxiolytic drugs' adverse events and to the need to
maintain optimal breathing, they are not used in first intention. Our choice is to use
conversational hypnosis during cannula replacement as it has already demonstrated interesting
effects in pain and anxiety. Conversational hypnosis does not present an induction phase like
in so-called hypnosis, it aims at leading the patient to perceive his/her world differently
with only a slight consciousness alteration.
Once the informed consent form is signed and when the cannula replacement has to be
performed, conversational hypnosis session will start right from the patient's room entrance
and end when the nurse will come out. The care will consist in aspiration, cleaning and
finally replacement of the cannula. Adverse events are expected to be related to the cannula
replacement itself: patients will be followed-up during a maximum of 7 days with one
follow-up visit which will take place 2 hours after cannula replacement and a second one
which can take place from the day after the replacement up to just before the following
replacement.