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SurgeryCOHEC2NCT05197972

Assessment of Cardiac Coherence Associated With Medical Hypnosis on Preoperative Anxiety in Oncological Surgery

A study testing cardiac coherence program coupled with hypnosis in people with Surgery and Oncology, run by Institut du Cancer de Montpellier - Val d'Aurelle at 4 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The investigator proposes to use the cardiac coherence technique (Cardiac Coherence) coupled with a hypnosis session to reduce pre-operative anxiety. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Surgery, Oncology
What is being tested?
cardiac coherence program coupled with hypnosis
Could I receive a placebo?
No, everyone receives an active treatment
How many people
296 participants
Where
4 sitesFrance
Study dates
1 Jun 2022to Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years old
  • Patient with a scheduled surgery for a cancer (suspected or declared) with a classic or ambulatory hospitalization
  • Patients requiring general anesthesia with or without associated loco-regional anesthesia or loco-regional anesthesia alone
  • Patient with a smartphone or a tablet or a computer and able to install the application
  • Inclusion of the patient minimum 7 days before the date of the surgery
  • Patient who signed the informed consent
  • Patient affiliated to a French social security system

Who cannot join

  • Emergency surgery
  • Plastic surgery for reconstruction: lipomodelling
  • Prophylactic surgery: no suspected or existing cancer
  • Bradycardia (< 50 beats/minute) with β-blockers
  • Severe heart failure with ventricular ejection fraction < 40%
  • Uncontrolled chronic pain for more than three months on morphine
Show all 11Show fewer
  • Patient with unstable epilepsy or respiratory pathology with rest dyspnea
  • Patient used to and having a regular and habitual practice of relaxation techniques such as yoga, hypnosis, sophrology, meditation, music therapy, virtual reality, ...
  • Medical (neurological, psychiatric, etc.) or psychological conditions not allow for participation in the protocol (completion of questionnaires and booklet, compliance with the cardiac coherence program coupled with hypnosis)
  • Deaf patient without hearing aids
  • Patient under guardianship or curatorship

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

France4 sites, 4 recruiting
  • Centre Léon Bérard

    Lyon

    Grégoire MD WALLON, +334 78 78 29 71, gregoire.wallon@lyon.unicancer.fr

    Grégoire MD WALLON

    Recruiting
  • Institut régional du cancer de Montpellier

    Montpellier, Hérault, 34298

    Jibba AMRAOUI, MD, 4 67 61 30 81 ext. +33, jibba.amraoui@icm.unicancer.fr

    Recruiting
  • Institut Universitaire du Cancer Toulouse - Oncopole

    Toulouse

    Régis FUZIER, MD, fuzier.regis@iuct-oncopole.fr

    Not yet recruiting
  • Institut Gustave Roussy

    Villejuif

    Alexandra VOICU, MD, +331 42 11 59 34, alexandre.voicu@gustaveroussy.fr

    Not yet recruiting

Other trials in France

About this study

Official title: Phase III Study Evaluating a Non-drug Intervention (NDI) Program by Fixed-frequency Guided Breathing (Cardiac Coherence) Associated With Medical Hypnosis on Preoperative Anxiety in Oncological Surgery

The investigator proposes to use the cardiac coherence technique (Cardiac Coherence) coupled with a hypnosis session to reduce pre-operative anxiety.

Read the detailed description

The perioperative period is recognized as anxiety-provoking for most patients. In oncology, 60 to 80% of patients suffer from stress throughout their treatment. If for some patients, this anxiety is more or less manageable, for others, it is the major concern with regard to their intervention.

For many years, pharmacological premedication, especially with benzodiazepines, has been the gold standard for the treatment of preoperative anxiety, but this systematic prescription is increasingly controversial, especially in populations most exposed to side effects, such as elderly subjects and patients with cardiac or respiratory pathologies.

The aim of this study is to propose an alternative to pharmacological premedication by a non-drug approach.

The two techniques (the Fixed Rate Guided Breathing Technique = cardiac coherence and hypnosis) can potentiate each other and become synergistic. Thus, for patients undergoing oncological surgery, regular practice of cardiac coherence coupled with hypnosis prior to their surgery should enable them to better manage perioperative anxiety and thus significantly reduce their level of anxiety on the day of their surgery.

The association of the 2 techniques combines several advantages:

  • It is totally "physiological", free and immediately available for the patient and without any undesirable effect;
  • It gives autonomy to the patient to manage his stress, making him independent of chemical molecules, the presence of a third party or expensive equipment.
  • It will allow oncology patients to use it throughout their care (invasive examinations, MRI imaging, heavy and complex care such as certain dressings, etc.)

This work will allow:

  • To give oncology patients the possibility to be actors of their care by a self-management of their anxiety in substitution or complement of a medicated approach;
  • To map anxiety in oncology surgery using a simple scale such as the EVA, which has not yet been done;
  • To identify the most anxious patients in order to provide them with the appropriate management (pharmacological and/or NMI) before their surgery;
  • To evaluate the correlation between the level of preoperative anxiety and the occurrence of postoperative adverse events;
  • To evaluate the correlation between the level of anxiety and the quality of recovery (QoR) and the postoperative experience (EVAN-G).

Patients in the experimental group will be interviewed to explain how to perform the cardiac coherence and hypnosis sessions at home before the surgery.

Conditions
Surgery, Oncology
Being tested
cardiac coherence program coupled with hypnosis
Medical subject headings
Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • cardiac coherence program coupled with hypnosisOther

    At home the patient will perform the cardiac coherence sessions between 7 days and a maximum of 15 days before the surgery through the application "Respirelax": 3 sessions per day, lasting 5 minutes with a breathing frequency of 6 cycles/min for a period of 7 days minimum and maximum 15 days.

    An audio tape read in a hypnotic tone can be listened to by the patient during the cardiac coherence program or at another time of the day (see the text of the audio tape).

Study groups in NCT05197972
Study groupRoleWhat they receive
Experimental groupExperimentalClassic management of the preoperative period with a cardiac coherence program coupled with hypnosis.
Receives: Other: cardiac coherence program coupled with hypnosis
Control groupNo interventionClassic management of the preoperative period

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Visual Analogue Scale (VAS) of global anxiety

    Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety).

    Measured: The morning of the surgery (Day 0) upon arrival in the operating room

Secondary outcomes (16)
  1. Program compliance

    Program compliance rate of patients in the experimental group. A patient is considered compliant if he declares to have completed at least 2/3 of the proposed Cardiac Coherence sessions + listening to hypnotic tape (at least 5 days /7).

    Measured: Between -15 to -7 days before surgery (Day -15 to Day -7) until the day of surgery (Day 0)

  2. Measurement of global and specific anxiety level by using a Visual Analogue Scale (VAS)

    Visual Analogue Scale (VAS) of anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety). The patient assesses his global and specific anxiety related to: surgery, anesthesia, COVID infectious risk, fear of the unknown, oncological disease

    Measured: Between -15 to -7 days before surgery (Day -15 to Day -7)

  3. Measurement of global anxiety level by using a Visual Analogue Scale (VAS)

    Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety).

    Measured: Between -15 to -7 days before surgery and the day of surgery (Day 0)

  4. The preoperative anxiety score by using the Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-report questionnaire comprising six questions that have been developed and validated to evaluate the preoperative anxiety of patients. This global index assesses three separate areas: anxiety about anaesthesia, anxiety about surgery, and the desire for information.

    The scale scores six items from 1 to 5 (1 = absence, 5 = extreme). The APAIS scale will be used to determine the psychological profile of patients between "blunting" and "monitoring" types

    Measured: Between -15 to -7 days before surgery

  5. VAS values and individual psycho-clinical characteristics

    Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor. The scale ranges from 0 (no anxiety) to 100 (maximum anxiety) (defined as VAS at Day 0 ≥ 40), and individual psycho-clinical characteristics (gender, smoking, psychological questionnaires).

    Measured: Between -15 to -7 days before surgery and the day of surgery (Day 0)

  6. Number of patients taking benzodiazepine

    Rate of patients taking benzodiazepines in the 2 groups

    Measured: The day after surgery (Day 1)

  7. Number of days of hospitalization

    Length of hospital stay in the 2 groups

    Measured: The day after surgery (Day -1) and up to 1 month

  8. VAS values and mode of hospitalization and importance of the surgical procedure

    Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor, and the mode of hospitalization (ambulatory or conventional) and the importance of the surgical procedure (minor, intermediate or major)

    Measured: The morning of the surgery (Day 0) upon arrival in the operating room

  9. Doses of hypnotic and morphine drugs

    Doses of hypnotic and morphine drugs administered during anesthetic induction (Day 0) in the 2 groups

    Measured: During anesthetic induction (Day 0)

  10. Value of preoperative VAS and adverse events

    Visual Analogue Scale (VAS) of global anxiety is a anxiety self-assessment scale that allows the patient to self-assess his or her anxiety using a cursor and adverse event variables: pain, agitation, postoperative nausea and vomiting (PONV), ...

    Measured: The morning of the surgery (Day 0) upon arrival in the operating room

  11. Number of Self-questionnaire completed

    Self-questionnaire completion rates for each of the 2 pre- and postoperative periods

    Measured: From the day of the anesthesia consultation until the end of the study

  12. Evaluation of the Vecu of General Anesthesia questionnaire (EVAN-G)

    The EVAN-G questionnaire includes 26 questions whose results are grouped together to define 6 dimensions: Attention Focus, Information, Privacy, Pain, Discomfort and Wait Times. From these scores, an overall satisfaction score is calculated. The total score of the six dimensions reduced to 100.

    Measured: Two day after surgery (Day 2)

  13. Visual Analogue Scale (VAS) of pain

    Visual Analogue Scale (VAS) of pain is a pain self-assessment scale that allows the patient to self-assess his or her pain using a cursor

    Measured: At 1, 2 and 3 month after surgery

  14. Quality of Recovery (QoR)

    The QoR-15 questionnaire assesses five dimensions of recovery : physical comfort; emotional state; physical independence; physiological support; and pain. Each item was rated on a ten-point Likert scale: none of the time, some of the time, usually, most of the time, and all the time. The total score of 15 ranges from 0 (poorest quality of recovery) to 150 (best quality of recovery).

    Measured: The day after surgery (Day 1)

  15. Insomnia Severity Index Scale (ISI)

    The Insomnia Severity Index (ISI) includes 7 questions which assesses the nature of the insomnia, the person's satisfaction with sleep, daily functioning and anxiety about sleep problems. Add scores for all seven items, sum from 0-7 = No clinically significant insomnia to 22-28 = Clinical insomnia (severe).

    Measured: The day after surgery (Day 1)

  16. VAS of on satisfaction with overall management and anesthesia

    Visual Analogue Scale (VAS) of on satisfaction with overall management and anesthesia is a satisfaction self-assessment scale that allows the patient to self-assess his or her satisfaction using a cursor. The scale ranges from 0 (not at all satisfied) to 100 (completely satisfied)

    Measured: The day after surgery (Day 1)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Jan 2022
  2. Study start1 Jun 2022
  3. Primary completionSep 2026 (estimated)
  4. Study completionDec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
Control group : classic management of the preoperative period Experimental group: classic management of the preoperative period with a cardiac coherence program coupled with hypnosis
Masking
None (open label)
Enrolment
296 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05197972
Sponsor's protocol ID
PROICM 2021-09 COH
Other IDs
2021-A01524-37
Acronym
COHEC2
Status last verified
Apr 2025
First submitted
8 Dec 2021
Last updated
16 Apr 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All data will be available after publication of the results in peer-reviewed revues, and in national and international meetings. It includes all de-identified participants' data, the study protocol, the statistical analysis plan and the clinical study report. The corresponding author will provide data and datasets generated and/or analyzed during the study upon reasonable request.

Publications

  • Pekcan M, Celebioglu B, Demir B, Saricaoglu F, Hascelik G, Yukselen MA, Basgul E, Aypar U. The effect of premedication on preoperative anxiety. Middle East J Anaesthesiol. 2005 Jun;18(2):421-33.

    PubMed 16438017
  • Shevde K, Panagopoulos G. A survey of 800 patients' knowledge, attitudes, and concerns regarding anesthesia. Anesth Analg. 1991 Aug;73(2):190-8. doi: 10.1213/00000539-199108000-00013.

    PubMed 1854034
  • Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, Ferreira MB. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001 Mar;45(3):298-307. doi: 10.1034/j.1399-6576.2001.045003298.x.

    PubMed 11207465
  • Miller SM. Coping with impending stress: psychophysiological and cognitive correlates of choice. Psychophysiology. 1979 Nov;16(6):572-81. doi: 10.1111/j.1469-8986.1979.tb01523.x. No abstract available.

    PubMed 515298
  • Miller SM, Mangan CE. Interacting effects of information and coping style in adapting to gynecologic stress: should the doctor tell all? J Pers Soc Psychol. 1983 Jul;45(1):223-36. doi: 10.1037//0022-3514.45.1.223.

    PubMed 6886967
  • Kindler CH, Harms C, Amsler F, Ihde-Scholl T, Scheidegger D. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients' anesthetic concerns. Anesth Analg. 2000 Mar;90(3):706-12. doi: 10.1097/00000539-200003000-00036.

    PubMed 10702461
  • Jamison RN, Taft K, O'Hara JP, Ferrante FM. Psychosocial and pharmacologic predictors of satisfaction with intravenous patient-controlled analgesia. Anesth Analg. 1993 Jul;77(1):121-5.

    PubMed 8317718
  • Kulik JA, Mahler HI, Moore PJ. Social comparison and affiliation under threat: effects on recovery from major surgery. J Pers Soc Psychol. 1996 Nov;71(5):967-79. doi: 10.1037//0022-3514.71.5.967.

    PubMed 8939044
  • Munoz HR, Dagnino JA, Rufs JA, Bugedo GJ. Benzodiazepine premedication causes hypoxemia during spinal anesthesia in geriatric patients. Reg Anesth. 1992 May-Jun;17(3):139-42.

    PubMed 1606095
  • Agelink MW, Majewski TB, Andrich J, Mueck-Weymann M. Short-term effects of intravenous benzodiazepines on autonomic neurocardiac regulation in humans: a comparison between midazolam, diazepam, and lorazepam. Crit Care Med. 2002 May;30(5):997-1006. doi: 10.1097/00003246-200205000-00008.

    PubMed 12006794
  • Maurice-Szamburski A, Auquier P, Viarre-Oreal V, Cuvillon P, Carles M, Ripart J, Honore S, Triglia T, Loundou A, Leone M, Bruder N; PremedX Study Investigators. Effect of sedative premedication on patient experience after general anesthesia: a randomized clinical trial. JAMA. 2015 Mar 3;313(9):916-25. doi: 10.1001/jama.2015.1108.

    PubMed 25734733
  • Lehrer PM, Gevirtz R. Heart rate variability biofeedback: how and why does it work? Front Psychol. 2014 Jul 21;5:756. doi: 10.3389/fpsyg.2014.00756. eCollection 2014.

    PubMed 25101026
  • Jiang H, White MP, Greicius MD, Waelde LC, Spiegel D. Brain Activity and Functional Connectivity Associated with Hypnosis. Cereb Cortex. 2017 Aug 1;27(8):4083-4093. doi: 10.1093/cercor/bhw220.

    PubMed 27469596
  • McCraty R, Atkinson M, Tiller WA, Rein G, Watkins AD. The effects of emotions on short-term power spectrum analysis of heart rate variability. Am J Cardiol. 1995 Nov 15;76(14):1089-93. doi: 10.1016/s0002-9149(99)80309-9.

    PubMed 7484873
  • Amraoui J, Pouliquen C, Fraisse J, Dubourdieu J, Rey Dit Guzer S, Leclerc G, de Forges H, Jarlier M, Gutowski M, Bleuse JP, Janiszewski C, Diaz J, Cuvillon P. Effects of a Hypnosis Session Before General Anesthesia on Postoperative Outcomes in Patients Who Underwent Minor Breast Cancer Surgery: The HYPNOSEIN Randomized Clinical Trial. JAMA Netw Open. 2018 Aug 3;1(4):e181164. doi: 10.1001/jamanetworkopen.2018.1164.

    PubMed 30646110

Questions about this trial

What is this clinical trial studying?

A study testing cardiac coherence program coupled with hypnosis in people with Surgery and Oncology, run by Institut du Cancer de Montpellier - Val d'Aurelle at 4 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 16 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Jean-Pierre BLEUSE, MD (4 67 61 31 02 ext. +33, jean-pierre.bleuse@icm.unicancer.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Visual Analogue Scale (VAS) of global anxiety (time frame: The morning of the surgery (Day 0) upon arrival in the operating room). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05197972, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Apr 2025.

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