Arezzo, September 16, 2024 – A device to induce medical hypnosis in Intensive Care patients in order to remove anxiety and pain.
This is what Dr. Raffaella Pavani’s team has been using for a couple of weeks in the Intensive Care Unit (ICU) of the San Donato Hospital in Arezzo, which she directs. The device is equipped with a wearable visor that reproduces about ten virtual realities and a pair of headphones in which to listen to a recorded voice that helps the person relax and thus divert attention from anxiety and pain. The device will remain in testing in the Department for two months.
«Patients in intensive care units are often agitated, confused and uncomfortable to the point of becoming delirious: this is called intensive care delirium – explains Dr. Roberto Bindi, Coordinating Nurse of the Intensive Care Unit at Arezzo Hospital -.
These symptoms are uncomfortable for the patient and often interfere with care and safety. In the worst cases, they can be life-threatening. In a critically ill patient, agitation, confusion, or both may result from the underlying medical condition, medical complications, treatment, or the resuscitation environment.
«Some causes of agitation or confusion in patients in intensive care – explains Dr. Raffaella Pavani, Director of UTI San Donato Arezzo – can derive from the underlying disease (head trauma, shock, ingestion of toxins), from pain and discomfort (caused by lesions, presence of devices such as endotracheal intubation, infusion lines, nasogastric tube), from complications (hypoxia, hypotension, sepsis, organ failure), from drugs such as sedatives and other drugs acting on the central nervous system, in particular opiates, benzodiazepines, H2 blockers, and antihistamines, from withdrawal from alcohol, drugs or both.
Agitation and confusion also caused by the environment of the intensive care unit, sleep deprivation caused by the noises, lights, or round-the-clock medical interventions typical of the ICU, fear of death, anxiety generated by unpleasant medical procedures and “care rituals”.
Staying in an intensive care unit is one of the most psychologically stressful situations. Numerous studies confirm high rates of depression, post-traumatic stress disorder (PTSD) and other psychological disorders among patients who have spent a long time in intensive care.
«According to some – adds Roberto Bindi – there is a direct relationship between hospitalization in intensive care and the subsequent development of a psychological disorder, while others highlight the complex interaction between the trauma of a very serious illness or injury and the life-saving interventions often administered in intensive care.
However, the conclusion that intensive care is an independent causal factor in trauma-related psychological outcomes has not yet been demonstrated.” “Of the approximately 1,000 patients treated each year,” Raffaella Pavani continues, “approximately 33.2% are people who are not extremely critical and therefore not asleep but awake and, often, neurologically competent.
Their conditions, although serious, determine a risk factor for the development of negative feelings such as anxiety, fear and stress, as well as the development of post-traumatic stress syndrome. For these reasons we decided to experiment with medical hypnosis using virtual reality”.
The device used at San Donato is able to reduce the pain and stress of patients thanks to medical hypnosis, helping them to face medical or surgical procedures that could be stressful or painful, and to face anxious and stressful moments during therapies and the stay in the department.
«A device designed to reduce costs and “collateral damage” of traditional methods of anesthesia to which patients are subjected – concludes Roberto Bindi – and which immerses the patient in a hypnotic sound and visual environment: music, texts, images and voices alternate and overlap to bring the person into the desired state of hypnosis, depending on the type of intervention that must be performed.
In this way the patient’s attention is focused on images and sounds that allow him to progressively find himself in a modified state of consciousness, in which the perception of pain tends to disappear and the mind focuses on a prompt recovery”.