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Akire SC, Bayraktar N. Outcomes of Pain Management Among Postoperative Patients: A Cross-sectional Study. J Perianesth Nurs 2024; 39:240-245. [PMID: 37897477 DOI: 10.1016/j.jopan.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE Postoperative pain management has always been a significant challenge for both hospital staff and surgical patients. Determination of pain management outcomes among surgically treated patients may help develop pain management strategies, improve health services that would yield better outcomes, and increase patient satisfaction. This study aimed to assess the outcomes of pain management among postoperative patients. DESIGN The study was a descriptive cross-sectional study. METHODS The research was performed on postoperative patients at two university hospitals in North Cyprus from July to September 2019. The study sample consisted of 90 patients from both hospitals. The Turkish Version of the revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR) was used for data collection. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was used to report the present study. FINDINGS This study showed that the overall mean for pain severity and the worst pain experienced by patients after 24 hours was slightly higher than medium. Examination of interference of the pain with functions demonstrated that patients experienced problems with physical activities and sleeping. The most experienced side effects were nausea and drowsiness, and the most common emotions were anxiety and helplessness during the postsurgery period. The satisfaction rate of the patients with postoperative pain management was relatively high. CONCLUSIONS A holistic approach with evidence-based practices is crucial for adequate postoperative pain management. The recommendations include the development of individual pain outcome strategies to improve overall satisfaction with pain management among postoperative patients.
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Affiliation(s)
| | - Nurhan Bayraktar
- Nursing Department, School of Health Sciences, Atilim University, Incek, Golbasi Ankara, Turkey.
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Tanrıverdi S, Parlar Kılıç S. The Effect of Progressive Muscle Relaxation on Abdominal Pain and Distension in Colonoscopy Patients. J Perianesth Nurs 2023; 38:224-231. [PMID: 36328945 DOI: 10.1016/j.jopan.2022.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 03/07/2022] [Accepted: 04/24/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE This study was conducted to examine the effect of progressive muscle relaxation on abdominal pain and distension in colonoscopy patients. DESIGN A randomized controlled experimental design. METHODS The experimental group was informed about progressive muscle relaxation (PMR) and an audio recording was provided. After the colonoscopy, abdominal pain (Visual Analogue Scale (VAS) pain) and distension (VAS distension) scores were assessed, then PMR was applied for 30 minutes and pain scores were determined again. VAS pain and VAS distension scores of the control group were determined after colonoscopy and 30 minutes later. VAS abdominal pain and VAS distension scores were evaluated at the 2nd, 4th, 8th, 12th, 16th, and 24th hour after the procedure on all patients. The day after the colonoscopy, post-test data were collected. FINDINGS The pretest VAS pain and VAS distension mean scores were similar in the intervention and control groups (P > .05). The mean VAS pain and VAS distension scores decreased significantly in the intervention group post procedure (P < .05). CONCLUSIONS PMR was determined to be effective in reducing abdominal pain and distension after colonoscopy.
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Zengin Aydın L, Doğan A. The Effect of Guided Imagery on Postoperative Pain Management in Patients Undergoing Lower Extremity Surgical Operations: A Randomized Controlled Trial. Orthop Nurs 2023; 42:105-112. [PMID: 36944205 DOI: 10.1097/nor.0000000000000929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Guided imagery distracts patients from disturbing feelings and thoughts, positively affects emotional well-being, and reduces pain by producing pleasing mental images. This study aimed to determine the effects of guided imagery on postoperative pain management in patients undergoing lower extremity surgery. This randomized controlled study was conducted between April 2018 and May 2019. This study included 60 patients who underwent lower extremity surgery. After using guided imagery, the posttest mean Visual Analog Scale score of patients in the intervention group was found to be 2.56 (1.00 ± 6.00), whereas the posttest mean score of patients in the control group was 4.10 (3.00 ± 6.00), and the difference between the groups was statistically significant (p <.001). Guided imagery reduces short-term postoperative pain after lower extremity surgery.
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Affiliation(s)
- Leyla Zengin Aydın
- Leyla Zengin Aydin, PhD, Department of Nursing, Ataturk Faculty of Health Sciences, Dicle University, Diyarbakır, Turkey
- Aysel Doğan, PhD, Department of Nursing, Faculty of Health Sciences, Toros University, Mersin, Turkey
| | - Aysel Doğan
- Leyla Zengin Aydin, PhD, Department of Nursing, Ataturk Faculty of Health Sciences, Dicle University, Diyarbakır, Turkey
- Aysel Doğan, PhD, Department of Nursing, Faculty of Health Sciences, Toros University, Mersin, Turkey
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Patil JD, Sefen JAN, Fredericks S. Exploring Non-pharmacological Methods for Pre-operative Pain Management. Front Surg 2022; 9:801742. [PMID: 35317192 PMCID: PMC8934410 DOI: 10.3389/fsurg.2022.801742] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/12/2022] [Indexed: 11/15/2022] Open
Abstract
The management of pain is an essential aspect of surgical care, and pain levels in post-operative patients vary case by case. Treating postoperative pain is crucial as it leads to better outcomes and reduces risk of long term pain. While post-operative analgesics has been the mainstay of treatment, this mini-review explores an emerging concept which is preoperative pain management, with promising potential. Such interventions include educating patients on the expected pain outcomes and available pain medications. Non-pharmacological methods such as relaxation exercises have also proven to be effective after abdominal surgery, and educating patients on the existence of such methods pre-operatively encourages them to make use of available therapies. A major area of importance is the pre-operative psychological and emotional wellbeing of patients, as it is a strong predictor of pain and pain prognosis. Cognitive Behavioral Therapy can be effectively used to tackle preoperative anxiety and reduce pain levels. Hypnosis is another developing modality for decreasing stress. Lastly, long term pre-operative opioid use has been linked with higher pain scores and longer pain duration. This provides the basis on which pre-operative opioid weaning can lead to favorable post-operative pain outcomes. While many of these methods have not been experimented on recipients of abdominal surgery in specific, it still paves the path for newer pain control strategies that can eventually be adopted for visceral surgery patients. This review points the reader and researchers to new and developing areas that hold the potential to revolutionize current established pain management guidelines.
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Bağci N, Doğan R. The relationship between pain beliefs and pain severity in liver transplant patients. Transpl Immunol 2022; 72:101564. [DOI: 10.1016/j.trim.2022.101564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/26/2022] [Accepted: 02/26/2022] [Indexed: 11/16/2022]
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Sayler MG, Domian Ommen CE, McKimmy BJ, Smith KA. Is it Feasible? A Quality Improvement Project to Integrate Complementary Therapy Into a Pain Management Program on a Transitional Care Unit. J Dr Nurs Pract 2022; 15:46-56. [DOI: 10.1891/jdnp-d-20-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BackgroundThe cost of pain to society is high, not only in dollars but in physical and emotional suffering. Undertreated pain in the geriatric population can lead to functional impairments and diminished quality of life. A transitional care unit (TCU) described having higher levels of moderate to severe pain than state and national levels in like facilities.ObjectiveA team of university faculty and students, and staff members from the TCU developed a quality improvement project to examine the feasibility of integrating complementary therapies to treat pain into clinical practice.MethodsThe team integrated three evidence-based complementary therapies into staff workflow.ResultsThe nursing and therapy staff reported minimal to no interruption to their workflow when patients used the complementary therapies. Staff expressed satisfaction with an expanded menu of pain management options. Patients reported statistically significant lower (p = 0.002) pain levels after using the complementary therapies and benefits beyond pain relief, including relaxation, stress reduction, and improved sleep.ConclusionAdding complementary therapies to the pain management program was feasible and the patients had less pain along with other benefits when using the therapies with standard care.Implications for NursingHaving additional methods for managing pain is beneficial and vital.
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Ozhanli Y, Akyuz N. The Effect of Progressive Relaxation Exercise on Physiological Parameters, Pain and Anxiety Levels of Patients Undergoing Colorectal Cancer Surgery: A Randomized Controlled Study. J Perianesth Nurs 2021; 37:238-246. [PMID: 34903440 DOI: 10.1016/j.jopan.2021.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 08/06/2021] [Accepted: 08/15/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE This study aimed to determine the effect of progressive relaxation exercises on physiological parameters, pain, anxiety, and serum cortisol levels in patients undergoing colorectal cancer surgery. DESIGN This study is a randomized controlled study and has been registered at the Clinical Trial Registry Center (ID: NCT04731428). METHODS The study was conducted on 63 patients (experimental group = 31, control group = 32), who were scheduled for elective laparoscopic-colorectal surgery in the general surgery clinic of a university hospital in Istanbul between March 2018 and May 2019 and met the inclusion criteria. The patients in the experimental group were given progressive relaxation exercises for 15 minutes preoperatively and on postoperative days 1, 2, and 3 after breathing exercise training. The routine treatments and care process of the patients in the control group were maintained. The preoperative and postoperative pain and anxiety levels of both groups were evaluated. Blood pressure, heart rate and respiratory rate, oxygen saturation, and serum cortisol levels were measured at certain time intervals before and after the relaxation exercise. FINDINGS The patients in the experimental group had lower postoperative pain and anxiety levels and a lower rate of using opioid analgesic on postoperative day 0 compared to the control group. Progressive relaxation exercise had no statistically significant effect on serum cortisol or physiological parameters (P > .05). CONCLUSIONS Progressive relaxation exercise did not affect cortisol levels and vital signs but decreased pain and anxiety, and relatively increased tissue oxygenation, appearing an effective, safe, and practicable nursing intervention.
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Affiliation(s)
- Yasemin Ozhanli
- Kocaeli University Faculty of Health Sciences / Umuttepe Campus, İzmit, Kocaeli, Turkey.
| | - Nuray Akyuz
- Istanbul University-Cerrahpasa Florence Nightingale Faculty of Nursing, Istanbul, Turkey
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Yılmaz M, Karabulut N. How Can we Improve the Comfort Level and Sleep Quality After Surgery? J Perianesth Nurs 2021; 37:100-104. [PMID: 34836766 DOI: 10.1016/j.jopan.2021.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/15/2021] [Accepted: 05/15/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE The aim of this study was to determine the effect of progressive relaxation exercises on the comfort level and sleep quality of patients undergoing lumbar disc herniation surgery. METHODS The study was conducted between July 2015 and October 2016 in the neurosurgery clinic. The sample consisted of 96 patients (n = 56, experimental patients; n = 40 control patients) randomized into groups. The data was collected by using the personal information form, The Perianesthesia Comfort Questionnaire, The General Comfort Questionnaire and Visual Analog Sleep Scale. FINDINGS In the postoperative General Comfort Scale that there was a statistically significant difference between the mean of the control group and experimental group on the final test (P < .05). When the Visual Analog Sleep Scale mean of the experimental and control group patients were compared between the groups, there was a statistically significant difference on the postoperative 2nd day and 3rd day (P < .05). CONCLUSION This study supports previous work that progressive relaxation exercises are feasible and effective to improve patient comfort levels after lumbar disc surgery.
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Affiliation(s)
- Mesut Yılmaz
- Health Services Vocational School, Operating Room Services Program, Muş Alparslan University, Muş, Turkey
| | - Neziha Karabulut
- The Nursing Faculty, Department of Surgical Nursing, Atatürk University, Erzurum, Turkey.
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Weekes DG, Campbell RE, Wicks ED, Hadley CJ, Chaudhry ZS, Carter AH, Pepe MD, Tucker BS, Freedman KB, Tjoumakaris FP. Do Relaxation Exercises Decrease Pain After Arthroscopic Rotator Cuff Repair? A Randomized Controlled Trial. Clin Orthop Relat Res 2021; 479:870-884. [PMID: 33835103 PMCID: PMC8051979 DOI: 10.1097/corr.0000000000001723] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/11/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Pain after rotator cuff repair is commonly managed with opioid medications; however, these medications are associated with serious adverse effects. Relaxation exercises represent a potential nonpharmacologic method of pain management that can be easily implemented without substantial adverse effects; however, the effects of relaxation exercises have not been studied in a practical, reproducible protocol after arthroscopic rotator cuff repair. QUESTIONS/PURPOSES (1) Does performing relaxation exercises after arthroscopic rotator cuff repair (ARCR) decrease pain compared with standard pain management medication? (2) Does performing relaxation exercises after ARCR decrease opioid consumption? (3) What proportion of patients who used the relaxation techniques believed they decreased their pain level, and what proportion continued using these techniques at 2 weeks? (4) Does performing relaxation exercises after ARCR affect shoulder function? METHODS During the study period, 563 patients were eligible for inclusion; however, only 146 were enrolled, randomized, and postoperatively followed (relaxation group: 74, control group: 72); 68% (384 of 563) of patients were not contacted due to patient and research staff availability. Thirty-three patients were unenrolled preoperatively or immediately postoperatively due to change in operative procedure (such as, only debridement) or patient request; no postoperative data were collected from these patients. Follow-up proportions were similar between the relaxation and control groups (relaxation: 80%, control: 81%; p = 0.90). The relaxation group received and reviewed educational materials consisting of a 5-minute video and an educational pamphlet explaining relaxation breathing techniques, while the control group did not receive relaxation education materials. Patients recorded their pain levels and opioid consumption during the 5 days after ARCR. Patients also completed the American Shoulder and Elbow Surgeons shoulder score preoperatively and 2, 6, 13, 18, and 26 weeks postoperatively. Linear mixed models were created to analyze postoperative pain, opioid consumption measured in morphine milligram equivalents (MMEs), and shoulder function outcomes. A per-protocol approach was used to correct for patients who were enrolled but subsequently underwent other procedures. RESULTS There was no difference in pain scores between the relaxation and control groups during the first 5 days postoperatively. There was no difference in pain scores at 2 weeks postoperatively between the relaxation and control groups (3.3 ± 3 versus 3.5 ± 2, mean difference -0.22 [95% CI -1.06 to 0.62]; p = 0.60). There was no difference in opioid consumption during the first 5 days postoperatively between the relaxation and control groups. The use of relaxation exercises resulted in lower 2-week narcotics consumption in the relaxation group than in the control group (309 ± 241 MMEs versus 442 ± 307 MMEs, mean difference -133 [95% CI -225 to -42]; p < 0.01). Sixty-two percent (41 of 66) of patients in the relaxation group believed the relaxation exercises decreased their pain levels. Fifty-two percent (34 of 66) were still performing the exercises at 2 weeks postoperatively. During the 6-month follow-up period, there was no difference in shoulder function between the relaxation and control groups. CONCLUSION The preoperative administration of quick, basic relaxation exercises allowed patients to use appreciably lower opioid analgesic doses over the first 2 weeks after ARCR, without any worsening of pain scores. We consider this result promising but preliminary; it is possible that a more intense mindfulness intervention-the one we studied here was disseminated using only a 5-minute video-would deliver reductions in pain and further reductions in opioid usage. LEVEL OF EVIDENCE Level II, therapeutic study.
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Affiliation(s)
- Danielle G. Weekes
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Richard E. Campbell
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Eric D. Wicks
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Christopher J. Hadley
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Zaira S. Chaudhry
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Aaron H. Carter
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Matthew D. Pepe
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Bradford S. Tucker
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Kevin B. Freedman
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
| | - Fotios P. Tjoumakaris
- D. G. Weekes, R. E. Campbell, E. D. Wicks, C. J. Hadley, Z. S. Chaudhry, A. H. Carter, M. D. Pepe, B. S. Tucker, K. B. Freedman, F. P. Tjoumakaris, The Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, PA, USA
- R. E. Campbell, The University of Virginia Medical Center, Charlottesville, VA, USA
- E. D. Wicks, Lakeland Regional Health Physician Group, Lakeland, FL, USA
- A. H. Carter, Town Center Orthopaedic Associates, Reston, VA, USA
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Ozkan B, Cavdar I. The Effect of Cold Therapy Applied to the Incision Area After Abdominal Surgery on Postoperative Pain and Analgesic Use. Pain Manag Nurs 2021; 22:775-782. [PMID: 33903052 DOI: 10.1016/j.pmn.2021.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cold therapy is one of the most common nonpharmacologic pain treatments. Despite the existence of many studies about cold therapy, few have examined the effects of cold therapy after abdominal surgery. AIMS The purpose of the study was to investigate the effect of cold therapy applied to the incision area after abdominal surgery on postoperative pain and analgesic use. DESIGN This study was a randomized controlled trial METHODS: The sample included 60 patients (30 control, 30 experimental) undergoing abdominal surgery. Researchers recorded information from a patient information form, a visual analogue scale (VAS), a pain evaluation form, and the vital signs recording form. RESULTS There was no statistically significant difference in pain level between the experimental and control groups as measured by VAS at postoperative hour 1 (p > .05). Furthermore, no statistically significant difference in VAS pain levels between groups was observed at postoperative hours 1, 2, and 8 prior to application of cold therapy (p > .05). Then, when cold therapy was applied at hours 1, 2 and 8, the pain level decreased significantly in the experimental group (p =.001). Pain also decreased in the control group between hours 1 and 8, but this decrease was not as great as that in the experimental group (p = .024). CONCLUSIONS Both groups had decreased pain levels, and the decrease in the experimental group was greater than in the control group but cold therapy had no statistically significant effect on analgesics use.
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Affiliation(s)
- Burcu Ozkan
- Faculty of Health Sciences, Istanbul Kent University, Istanbul, Turkey.
| | - Ikbal Cavdar
- Florence Nightingale Faculty of Nursing, Surgical Nursing Department, "Istanbul University-Cerrahpaşa".
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Bahçeli A, Karabulut N. The Effects of Progressive Relaxation Exercises following Lumbar Surgery: A Randomized Controlled Trial. Complement Med Res 2020; 28:114-122. [PMID: 32882693 DOI: 10.1159/000509055] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 05/28/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM This study aimed to examine the effect of progressive relaxation exercises on anxiety, pain, and sleep quality among patients who underwent surgery for lumbar disc hernia. MATERIALS AND METHODS This randomized, non-blinded, parallel-group clinical trial was conducted with 97 patients who had a lumbar microdiscectomy. On the first, second, and third day of the postoperative period, routine nursing care was performed on the control group, while additional progressive relation exercises were performed on the experimental group. RESULTS When the experimental and control groups were compared regarding SAI, VAS-P, and VAS-S scores before the surgery, no differences were found (p > 0.05); however, there were significant differences in the scores obtained on the mornings of the second and third days after the surgery (p < 0.05). CONCLUSIONS Progressive relation exercises used as a supportive nursing intervention were found to reduce pain and anxiety and increase sleep quality.
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Affiliation(s)
- Aybike Bahçeli
- Department of Surgical Nursing, Health College, Bozok University, Yozgat, Turkey
| | - Neziha Karabulut
- Department of Surgical Nursing, The Nursing Faculty, Atatürk University, Erzurum, Turkey,
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Maiti T, Bhattacharya D, Das S. Pain or fear of pain: which incapacitates us more? A complex opioid story. Pain Manag 2020; 10:279-281. [PMID: 32777993 DOI: 10.2217/pmt-2020-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Tanay Maiti
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, India
| | | | - Saibal Das
- Department of Clinical Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
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Kısaarslan M, Aksoy N. Effect of Progressive Muscle Relaxation Exercise on Postoperative Pain Level in Patients Undergoing Open Renal Surgery: A Nonrandomized Evaluation. J Perianesth Nurs 2020; 35:389-396. [DOI: 10.1016/j.jopan.2019.12.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 12/26/2019] [Accepted: 12/27/2019] [Indexed: 10/24/2022]
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Kazak A, Ozkaraman A. The Effect of Progressive Muscle Relaxation Exercises on Pain on Patients with Sickle Cell Disease: Randomized Controlled Study. Pain Manag Nurs 2020; 22:177-183. [PMID: 32224022 DOI: 10.1016/j.pmn.2020.02.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 02/04/2020] [Accepted: 02/23/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE The study aimed to evaluate the effect of progressive muscle relaxation exercises on pain in patients with sickle cell disease. MATERIALS-METHOD This randomized controlled interventional study was conducted in a hospital in Mersin, Turkey between October 2017 and July 2018. The study sample comprised 58 patients who were aged >18 years, conscious, had sickle cell disease, reported pain, and were treated with non-opioid or weak opioid analgesic based on the physician's recommendation (treatment group = 29, control group = 29). Data were collected by the individual presentation form and visual analog scale. During the study, both groups were treated with analgesics prescribed by the physician for three days. In addition to the analgesics, the treatment group was performed progressive muscle relaxation exercises for 30 minutes whereas the control group was rested. Pain level of both groups was evaluated at three time points every day for three days. In the study, frequency distributions and descriptive statistics were presented for categorical and numerical variables, respectively. Chi-square analysis, independent samples t-test, Mann-Whitney U test, three-way ANOVA, and Sidak test were used to analyze the difference between the variables. RESULTS The mean age of the patients was 29.59 ± 6.94 years, and 53.4% of the patients were female and 69% were single. The mean pain score of the treatment group at the third time point on days 1, 2, and 3 was significantly lower than the control group (p < .05). There was no statistically significant difference between the two groups in terms of coping methods for pain, pain location, and complaints accompanying pain (p > .05). CONCLUSION Progressive muscle relaxation exercises were found to be effective in the pain management of patients with sickle cell anemia.
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Affiliation(s)
- Aysun Kazak
- Vocational School of Health Services, Gumushane University, Gumushane, Turkey
| | - Ayse Ozkaraman
- Department of Nursing, Eskisehir Osmangazi University, Eskisehir, Turkey.
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Ju W, Ren L, Chen J, Du Y. Efficacy of relaxation therapy as an effective nursing intervention for post-operative pain relief in patients undergoing abdominal surgery: A systematic review and meta-analysis. Exp Ther Med 2019; 18:2909-2916. [PMID: 31555379 PMCID: PMC6755420 DOI: 10.3892/etm.2019.7915] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Accepted: 08/09/2019] [Indexed: 12/22/2022] Open
Abstract
This systematic review and meta-analysis was conducted with the aim of assessing the efficacy of relaxation techniques for pain relief in patients undergoing abdominal surgery. The electronic search of the PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar databases was performed for studies in the English language published up to May, 2019. A total of 12 studies were included in the review and 7 in the meta-analysis. In total, 4 relaxation techniques were utilized in the included studies: Jaw relaxation, Benson's relaxation, progressive muscle relaxation (PMR) and systematic relaxation. Of the 12 included, 10 studies demonstrated statistically significant pain relief in the relaxation group as compared to the controls. The data of 422 patients in the relaxation group and 424 patients in the control group were pooled for a meta-analysis, which indicated that patients undergoing abdominal surgery had significantly greater pain relief following relaxation therapy as compared to the controls [random: standardized mean difference (SMD), −1.15; 95% CI, −2.04 to −0.26; P<0.00001). The overall quality of the studies was not high. On the whole, despite trials demonstrating the benefits of relaxation therapy for immediate pain relief in patients post-abdominal surgery, there is lack of high-quality scientific evidence substantiating its routine use. There is a need for more robust randomized control trials (RCTs) utilizing standardized relaxation protocols to provide further evidence on this subject.
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Affiliation(s)
- Wanxia Ju
- Department of General Surgery, the Fifth Central Hospital of Tianjin, Tianjin 300450, P.R. China
| | - Lili Ren
- Department of General Surgery, the Fifth Central Hospital of Tianjin, Tianjin 300450, P.R. China
| | - Jun Chen
- Department of General Surgery, the Fifth Central Hospital of Tianjin, Tianjin 300450, P.R. China
| | - Yuman Du
- Department of General Surgery, the Fifth Central Hospital of Tianjin, Tianjin 300450, P.R. China
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Sarikoc G, Sarmasoglu S, Tuzer H, Elcin M, Burn CL. Intervention for Standardized Patients' Anxiety After “Receiving Bad News” Scenarios. Clin Simul Nurs 2018. [DOI: 10.1016/j.ecns.2018.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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O'Donnell KF. Preoperative Pain Management Education: An Evidence-Based Practice Project. J Perianesth Nurs 2018; 33:956-963. [PMID: 30449444 DOI: 10.1016/j.jopan.2017.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 11/01/2017] [Accepted: 11/04/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE The purpose of this evidence-based practice project was to evaluate the effectiveness of a preoperative pain management patient education intervention on improving patients' pain management outcomes. DESIGN The project was conducted in an outpatient general surgery service at a teaching institution for patients undergoing same-day surgery. Intervention patients received one-on-one education on postoperative pain management including how to take medications, managing medication side effects, using nonpharmacologic methods, and reporting inadequate postoperative pain control. Comparison patients received general education from multiple health care providers, and this information may not have been consistent. METHODS Intervention patients received education at the first preoperative clinic visit. Patients in the intervention and comparison groups completed the Revised American Pain Society Patient Outcome Questionnaire during their first postoperative clinic visit. Results were analyzed by the Mann-Whitney U test/Wilcoxon rank sum test. FINDINGS A 12-month project (N = 99) showed statistically significant results (P = .020 and P = .001, respectively) in questions about side effects and whether the patient was encouraged to use nonpharmacologic methods to reduce pain. The intervention group reported the effects of pain on mood (P = .067) and use of nonpharmacologic methods (P = .052); however, these results were not statistically significant. CONCLUSIONS More intervention patients than comparison patients reported medication side effects and were encouraged to use nonpharmacologic methods for reducing postoperative pain. Intervention patients also reported the effects of pain on mood and the use of nonpharmacologic methods more frequently than comparison patients. Preoperative pain management education may increase patients' knowledge in key areas of postoperative pain management to prevent negative outcomes.
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18
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Aydemir Ö, Aslan FE, Karabacak Ü, Akdaş Ö. The Effect of Exaggerated Lithotomy Position on Shoulder Pain after Laparoscopic Cholecystectomy. Pain Manag Nurs 2018; 19:663-670. [PMID: 29934129 DOI: 10.1016/j.pmn.2018.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 04/05/2018] [Accepted: 04/25/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND The exaggerated lithotomy position with the expertise of nurses can be successful solution for the patients who have the postoperative shoulder pain after laparoscopic cholecystectomy. AIMS This study aimed to determine the effect of applying an exaggerated lithotomy positions to patients who had laparoscopic cholecystectomy to relieve shoulder pain. The study was conducted on nonrandomized groups and made as a semiexperimental study with a pretest/post-test control group design. Design, Settings, and Subjects/Participants: The study was conducted on 102 patients who had elective laparoscopic cholecystectomy and agreed to participate in this study after they met the inclusion-exclusion criteria in the general surgery clinic of a training and research hospital in Istanbul between December 12, 2012, and June 30, 2013. METHODS The pain levels (10 minutes before and after positioning) and peripheral oxygen saturation (SPO2) levels (1 minute, 5 minutes, and 10 minutes before and after positioning-total 6 times) of the patients were measured using a visual analog scale and pulse oximetry, respectively. The pain levels and the analgesic (pethidine hydrochloride and diclofenac sodium) usage of the patients in both the experimental and the control group were compared. RESULTS The exaggerated lithotomy position appreciably lowered the shoulder pain of the patients in the experimental group (t = 12.663; p = .000 < .001). It also increased peripheral saturation levels of the patients more rapidly compared with those in the control group receiving analgesics (t = 17.693; p = .000 < .005). In addition, it decreased the need to use additional analgesics and opioids (t = 2.14; p = .037). CONCLUSIONS In this study the exaggerated lithotomy position was found to be fast and effective for relieving shoulder pain after laparoscopic cholecystectomy, decreased the need to use additional analgesics and opioids, and, in conjunction with pain control, also contributed to improvements in respiratory functions.
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Affiliation(s)
- Özgül Aydemir
- Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
| | | | - Ükke Karabacak
- School of Nursing, Acıbadem University, Istanbul, Turkey
| | - Özlem Akdaş
- Palliative Care Service, Department of Anesthesiology and Reanimation, Uşak Public Hospital, Uşak, Turkey
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O'Donnell KF. Preoperative pain management education: a quality improvement project. J Perianesth Nurs 2017; 30:221-7. [PMID: 26003769 DOI: 10.1016/j.jopan.2015.01.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/18/2015] [Accepted: 01/18/2015] [Indexed: 11/25/2022]
Abstract
The management of pain is one of the greatest clinical challenges for nurses who care for patients during the postoperative period. It can be even more challenging for patients who must manage their own pain after discharge from the health care facility. Research shows that postoperative pain continues to be undermanaged despite decades of education and evidence-based guidelines. Ineffective management of postoperative pain can negatively impact multiple patient outcomes. The purpose of this quality improvement project was to evaluate the effectiveness of a preoperative pain management patient education intervention on improving patients' postoperative pain management outcomes. The project was conducted with patients undergoing same-day laparoscopic cholecystectomy in an outpatient general surgery service at a teaching institution. Patients in the intervention and comparison groups completed the American Pain Society Patient Outcome Questionnaire-Revised during their first postoperative clinic visit 2 weeks after surgery. Results showed that patients who received the preoperative education intervention reported less severe pain during the first 24 hours postoperatively, experienced fewer and less severe pain medication side effects, returned to normal activities sooner, and used more nonpharmacologic pain management methods postoperatively compared with those who did not receive the education.
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Solehati T, Rustina Y. Benson Relaxation Technique in Reducing Pain Intensity in Women After Cesarean Section. Anesth Pain Med 2015; 5:e22236. [PMID: 26161315 PMCID: PMC4493735 DOI: 10.5812/aapm.22236v2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/01/2014] [Accepted: 10/14/2014] [Indexed: 11/17/2022] Open
Abstract
Background: Post-cesarean section women experience pain due to operative trauma. Pain sensation can be reduced by pain management. Pharmacological and non-pharmacological treatments can be used. The Benson Relaxation Technique is a non-pharmacological way suitable to reduce pain, but there are limited studies on its post-cesarean section use. Objectives: This study aimed to determine the effect of Benson Relaxation Technique in reducing pain intensity in women after cesarean section. Patients and Methods: This was a quasi-experiment study with pre and post-test design. A prospective, not blind, randomized assign, two groups parallel study was conducted in Cibabat hospital Cimahi as intervention group (IG) and Sartika Asih hospital as control group (CG). Post cesarean section women with quota sampling who met the inclusion criteria were consecutively assigned to either experimental (n = 30) or control group (n = 30). Women in the experimental group received the Benson relaxation technique and those in the control group received regular care from the health workers. The outcome pain severity was measured by visual analogue scale. Those instruments were applied before and after intervention. Results: The mean of pain score before intervention at CG was 4.43 cm. It was decreased to 4.40 cm (1 min), 4.27 cm (12 h), 4.10 cm (24 h), 4.00 cm (36 h), 3.93 cm (48 h), 3.83 cm (60 h), 3.67 cm (72 h) and 3.51 cm (84 h). Meanwhile, the IG was 4.97 cm. It was decreased to 4.90 cm (1 min), 4.23 cm (12 h), 3.57 cm (24 h), 3.03 cm (36 h), 2.77 cm (48 h), 2.73 cm (60 h), 2.67 cm (72 h) and 2.63 cm (84 h). The study found a significant difference comparing pain intensity before and after the intervention in CG and IG (P = 0.001), but pain reduced in IG more than CG. Conclusions: The Benson relaxation could reduce pain intensity in women after cesarean section.
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Affiliation(s)
- Tetti Solehati
- Faculty of Nursing, Padjadjaran University, Bandung, Indonesia
- Corresponding author: Tetti Solehati, Faculty of Nursing, Padjadjaran University, Bandung, Indonesia. Tel: +62-227795596, E-mail:
| | - Yeni Rustina
- Faculty of Nursing, University of Indonesia, Jakarta, Indonesia
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Effect of Cyclooxygenase-2-Specific Inhibitors on Postoperative Analgesia after Major Open Abdominal Surgery. Pain Manag Nurs 2015; 16:242-8. [DOI: 10.1016/j.pmn.2014.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 06/24/2014] [Accepted: 07/02/2014] [Indexed: 11/22/2022]
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Meyers RS. A Clinician’s Perspective on Treating Patients Suffering from Insomnia and Pain. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2015. [DOI: 10.1007/s10942-015-0214-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Evaluation of the effect of Benson's relaxation technique on pain and quality of life of haemodialysis patients: A randomized controlled trial. Int J Nurs Stud 2014; 51:964-73. [DOI: 10.1016/j.ijnurstu.2013.11.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 11/11/2013] [Accepted: 11/14/2013] [Indexed: 11/21/2022]
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Keshet Y, Attias S, Ben-Arye E, Shaham M, Grimberg O, Schiff E. Integrative Complementary Medicine for Treatment of Bariatric Perioperative Symptoms: Patients' Experiences and Staff Evaluations. Bariatr Surg Pract Patient Care 2014; 8:108-112. [PMID: 24761369 DOI: 10.1089/bari.2013.9980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND A unique integrative complementary medicine (CM) pilot program was launched in a general surgery department at a public teaching hospital in Israel. In addition to standard supportive care, CM treatments are used to support patients undergoing laparoscopic sleeve gastrectomy (LSG) in coping with perioperative distresses. We examined the experiences of patients and how the nursing staff evaluate these treatments. METHODS Qualitative semi-structured open-ended interviews were used. RESULTS Most patients reported that the treatments helped them to cope better with preoperative anxiety, and facilitated postoperative breathing and pain relief. Nurses reported that CM treatments enabled them to reduce doses of analgesics. Both patients and nurses suggested that preoperative CM treatment facilitated a better postoperative CM-associated outcome. CONCLUSIONS Integrative perioperative CM treatments improved pain and anxiety care in patients undergoing LSG. More research is needed to examine CM efficacy in improving standard LSG perioperative supportive care and to evaluate cost effectiveness.
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Affiliation(s)
- Yael Keshet
- Department of Sociology and Anthropology, Western Galilee Academic College , Akko, Israel
| | - Samuel Attias
- Complementary/Integrative Surgery Service, Bnai Zion Medical Center , Haifa, Israel
| | - Eran Ben-Arye
- Lin Medical Center , Clalit Health Services, Haifa and Western Galilee District, Israel
| | - Miri Shaham
- PACU Service, Bnai Zion Medical Center , Haifa, Israel
| | - Ofra Grimberg
- Surgery Department, Bnai Zion Medical Center , Haifa, Israel
| | - Elad Schiff
- Internal Medicine Department, Bnai Zion Medical Center , and The International Center for Health, Law & Ethics, Haifa, Israel
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Rejeh N, Heravi-Karimooi M, Vaismoradi M, Jasper M. Effect of systematic relaxation techniques on anxiety and pain in older patients undergoing abdominal surgery. Int J Nurs Pract 2013; 19:462-70. [PMID: 24093737 DOI: 10.1111/ijn.12088] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Inadequate pain control in older patients who have undergone abdominal surgery can lead to many complications. This study investigates the effect of systematic relaxation techniques on pain and anxiety in older patients undergoing abdominal surgery. One hundred twenty-four patients were randomly assigned into the experimental and control groups. The systematic relaxation techniques consisted of older patients in the experimental group slowly reading relaxing sentences during recovery in ambulation after the surgery. Patients' satisfaction with pain and anxiety relief was recorded, as was their use of opioid analgesia. Statistically significant differences in pain and anxiety, and in analgesic use, were reported between the patients in experimental and control groups after the intervention. These relaxation techniques can be incorporated into the care plan to reduce pain and anxiety after surgery as well as offering a measure for increasing the patients' independence in pain management control.
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Affiliation(s)
- Nahid Rejeh
- Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Health of the Elderly Research Group, Tehran, Iran
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Bai J, Hsu L. Pain status and sedation level in Chinese children after cardiac surgery: an observational study. J Clin Nurs 2012; 22:137-47. [PMID: 22978412 DOI: 10.1111/j.1365-2702.2012.04263.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study explored current pain status, sedation level and their trajectories in Chinese children after cardiac surgery. Background. Pain and sedation management are fundamental care practices in the critical care setting, yet they both are frequently under-implemented for children after major surgery. DESIGN Repeated observational design. METHODS This study was conducted in a paediatric medical centre in Shanghai, China where 170 children who underwent cardiac surgery were recruited. Pain was measured with the face, legs, activity, cry, consolability scale and sedation levels with the COMFORT Behaviour Scale at 18 fixed time-points for three consecutive postoperative days. Results. The study indicated that 95 children (55·9%) received continuous opioids for pain relief, and 61 children (35·9%) received no analgesics. Multiple sedatives were used for these children, including bolus phenobarbital for 117 children (68·8%), phenergan for 81 children (47·6%) and midazolam for three children (1·8%). The mean pain scores significantly decreased throughout the operation day (POD-0) to the 2nd postoperative day (POD-2) with the lowest score on POD-2. Less than 5% of pain assessments were identified as moderate to severe across all 2815 observations. The sedation scores significantly increased through POD-0 to POD-2 with the highest score on POD-2. The rate of over-sedation was 50·3% with <1% under-sedation occurring among all the observations. Results also suggested that the length of stay in the cardiac intensive care unit was a predictor of increased analgesic usage in the critical care setting (odds ratio: 1·72). CONCLUSIONS Usage of analgesic and sedative agents in cardiac intensive care unit was variable and children experienced low pain scores but a high rate of over-sedation, indicating that healthcare providers should address ways to improve postoperative pain and sedation management in this population. RELEVANCE TO CLINICAL PRACTICE The pain and sedation status for children after cardiac surgery changed across the postoperative days. Healthcare providers should be trained in the use of reliable tools to accurately monitor children's pain and sedation levels.
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Affiliation(s)
- Jinbing Bai
- School of Nursing, Tianjin Medical University, Tianjin, China
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