HypnoChild: A prospective randomized trial to reduce perioperative anxiety and postoperative discomfort in children using a hypnosis intervention before tonsillotomy and adenoidectomy

Introduction: Children undergoing tonsillotomy (TT) or adenoidectomy (AT) often suffer from anxiety before and pain or nausea after the procedure. Greater preoperative anxiety in children and their parents is associated with increased postoperative discomfort. The aim of the HypnoChild study is to reduce perioperative anxiety with a preoperative hypnosis intervention and thereby alleviate postoperative discomfort. Material/Methods: In a previous pilot study, we developed a narcosis comic with a little monkey as the protagonist to reduce children's preoperative anxiety. In HypnoChild, we investigated whether a hypnosis audio intervention further reduces children's perioperative anxiety. Here, the little monkey describes the surgery as an adventurous space journey. We included children 3-6 years old receiving TT or AT. 34 children prepared for surgery with the hypnosis audio intervention in addition to the comic (comic+hypnosis group), while 30 children received the comic only (comic group). All children received premedication by midazolam. We measured children's subjective well-being before and after surgery, parents' anxiety before surgery, children's anxiety during surgery, and children's postoperative pain and nausea. Results: Children showed high well-being before and after surgery in both groups. Parents' anxiety was on a moderate level in both groups. Children's anxiety was low to moderate in both groups during surgery. In the postoperative telephone interviews, children reported medium pain ratings in both groups with no significant differences in any postoperative outcome between groups. Conclusion: Our study shows that all children participating in our study reported high well-being and low anxiety undergoing TT or AT. We conclude that apparently children already received adequate preoperative treatment by routine care. In future studies, it should be assessed if the combination of non-medical interventions like comic and hypnosis shows an additive effect in non-medicated children. This research was funded by a DFG grant to Dr. Barbara Schmidt, SCHM 3129/5-1