Hypnosis for Postoperative Pain Management Following Colectomies: A Single-Center Randomized Controlled Feasibility Trial

BACKGROUND: Postoperative pain management after colectomy remains challenging, with opioid-related complications impacting recovery. This study evaluates the feasibility of implementing clinical hypnosis as an adjunctive intervention. OBJECTIVE: To determine the feasibility of conducting a full-scale randomized controlled trial investigating hypnosis for postcolectomy pain management. METHODS: Single-center randomized controlled feasibility trial. SETTING: District general hospital in South-West England (July 2023 - February 2024). PATIENTS: Forty-one adults undergoing elective colectomy. INTERVENTIONS: Participants were randomized to standard care or standard care plus 3 perioperative hypnosis sessions (preoperatively, first- and third-day postsurgery). MAIN OUTCOME MEASURES: Primary: recruitment rates, retention, and intervention adherence. secondary: pain scores (numeric pain scale), analgesic requirements, and complications. RESULTS: Recruitment achieved 58% (41/71 eligible patients), with 90% retention and 92.5% intervention adherence. The hypnosis group demonstrated pain reductions approximating the minimum clinically important difference, providing signals of potential clinical benefit following sessions: at 24-hour postsurgery, median pain decreased from 5.0 to 2.5 (median difference -2.0, 95% confidence interval -2.5 to -1.0), and at day 3, from 4.0 to 1.5 (median difference -2.5, 95% confidence interval -3.0 to -1.5). Between-group comparisons showed lower pain in the hypnosis group at 24 hours (median 5.0 vs 6.0, median difference -1.2, 95% confidence interval -2.3 to -0.1). LIMITATIONS: Single-center design limits generalizability; participant and staff blinding was unfeasible; hypnotizability was not assessed. CONCLUSIONS: Hypnosis is feasible in acute surgical settings, with trends supporting pain reduction and positive patient experiences. A definitive trial is warranted to determine efficacy for postcolectomy pain management. See Video Abstract.Registration number: ClinicalTrials.gov: NCT06499909.