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USE
OF
HYPNOSIS IN CONTROLLING
LUMBAR PUNCTURE DISTRESS IN
AN ADULT NEEDLE-PHOBIC
DEMENTIA PATIENT
ERIC
P.
SIMON'
AND
MONIQUE
M.
CANONICO""
Tripler Regional Medical Center, Honolulu, Hawaii
Abstract:
Lumbar punctures areoftenvital to the medicalmanagement
of patients with suspected organic pathology, yet they are commonly
met with such distress that medical risk is significantly increased, and
patient rapport is significantlydecreased, further compromisingmedi-
cal treatment. Although the use
of
hypnosis for lumbar punctures
is
well established in pediatric patients, no literature exists for adult
patients. Similarly, there
is
no extant research regarding hypnosis
for
dementia patients, likely due
to
the limiting factors of impaired atten-
tion
and concentration.With these factors in mind,
a
method
for
incor-
porating hypnosis into
a
lumbar puncture procedure
is
described for
a
needle-phobic adult patient suffering from dementia.
Lumbar Puncture (LP) is a procedure that
is
often vital to the medical
management of patients with suspected organic pathology.
LPs
can
be
very
painful and
anxiety-provoking, causing physical
and
psychologi-
cal discomfort to patients, which
may
then
lead to troubled relations
with
medical staff
and
ultimately to poorer treatment compliance
and
compromised outcomes.
In
addition,
an
LP
contains significant medical
risk and requires great precision. Thus, a patient's difficulty with
the
procedure can negatively impact
the
physician's ability to administer
the
procedure
by
lengthening
the
overall time or even preventing its
completion.
There is
ample
evidence that hypnosis can significantly alleviate pro-
cedural distress dur i ng
LPs
i n pediatric populat ions (Hageman-
Wenselaar, 1988; Kellerman, Zeltzer, Ellenberg,
&
Dash,
1983;
Milling
&
Costantino, 2000;
Rape
&
Bush, 1994; Zeltzer
&
LeBaron, 1982).There
is
also substantial
evidence that hypnosis can
be
a very effective technique
for adul t s experiencing chronic pa i n (Barber, 1996; Chaves, 1994;
Manuscript
submitted
March
19,1999;
final
revision received
June
1,1999.
'Now
at
the
Sierra
Vista
Regional
Medical
Center.
'The
views
expressed
in this
manuscript
are
those
of
the
authors
and
do
not
reflect
the
official
policy
of
the
Department
of
the
Army,
Department
of
Defense,
or
the
U.S.
Govern-
ment.
'Address
correspondence
to
Eric
P.
Simon,
Ph.D.,
ABPP, Department
of
Neurological
and
Physical
Rehabilitation,
Sierra
Vista
Regional
Medical
Center,
San Luis
Obispo,
CA
93420,
or
EricSimon@Yahoo.com.
The
Internutiowl foumul O/Clinicul
und
Experimental
Hypnosis,
Vol.
49,
No.
1,
January
2001 56-67
0
2001
The
I n tma t i ow l lournu!
ofclinicul
and
Experimental
Hypnosis
56
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