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Thevi T, Abas AL, Vossmerbaeumer U. Effects of Music on Pain and Autonomic Functions of Heart Rate, Blood Pressure, Nausea and Vomiting After Major Surgery—Meta-analysis. Indian J Surg 2022. [DOI: 10.1007/s12262-021-03032-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Henrich MC, Steffen Frahm K, Coghill RC, Kæseler Andersen O. Spinal nociception is facilitated during cognitive distraction. Neuroscience 2022; 491:134-145. [DOI: 10.1016/j.neuroscience.2022.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/25/2022]
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Prakash R, Singh P, Arya A, Singh M, Khan M. Effect of spiritual music on old-age patients undergoing lower limb surgery under spinal anesthesia. Anesth Essays Res 2022; 16:208-212. [DOI: 10.4103/aer.aer_25_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/04/2022] Open
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Gorsky K, Black ND, Niazi A, Saripella A, Englesakis M, Leroux T, Chung F, Niazi AU. Psychological interventions to reduce postoperative pain and opioid consumption: a narrative review of literature. Reg Anesth Pain Med 2021; 46:893-903. [PMID: 34035150 DOI: 10.1136/rapm-2020-102434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 05/13/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Evidence suggests that over half of patients undergoing surgical procedures suffer from poorly controlled postoperative pain. In the context of an opioid epidemic, novel strategies for ameliorating postoperative pain and reducing opioid consumption are essential. Psychological interventions defined as strategies targeted towards reducing stress, anxiety, negative emotions and depression via education, therapy, behavioral modification and relaxation techniques are an emerging approach towards these endpoints. OBJECTIVE This review explores the efficacy of psychological interventions for reducing postoperative pain and opioid use in the acute postoperative period. EVIDENCE REVIEW An extensive literature search was conducted in MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Medline In-Process/ePubs, Embase, Ovid Emcare Nursing, and PsycINFO, Web of Science (Clarivate), PubMed-NOT-Medline (NLM), CINAHL and ERIC, and two trials registries, ClinicalTrials.Gov (NIH) and WHO ICTRP. Included studies were limited to those investigating adult human subjects, and those published in English. FINDINGS Three distinct forms of psychological interventions were identified: relaxation, psychoeducation and behavioral modification therapy. Study results showed a reduction in both postoperative opioid use and pain scores (n=5), reduction in postoperative opioid use (n=3), reduction in postoperative pain (n=5), no significant reduction in pain or opioid use (n=7), increase in postoperative opioid use (n=1) and an increase in postoperative pain (n=1). CONCLUSION Some preoperative psychological interventions can reduce pain scores and opioid consumption in the acute postoperative period; however, there is a clear need to strengthen the evidence for these interventions. The optimal technique, strategies, timing and interface requires further investigation.
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Affiliation(s)
- Kevin Gorsky
- Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - Nick D Black
- Department of Anaesthesia, Belfast Health and Social Care Trust, Belfast, UK
| | - Ayan Niazi
- Department of Biology, Trent University, Peterborough, Ontario, Canada
| | - Aparna Saripella
- Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
| | - Marina Englesakis
- Library & Information Services, University Health Network, Toronto, Ontario, Canada
| | - Timothy Leroux
- The Arthritis Program, University Health Network, Toronto, Ontario, Canada
| | - Frances Chung
- Anesthesia, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | - Ahtsham U Niazi
- Department of Anesthesia and Pain Management, University of Toronto, Toronto, Ontario, Canada
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Dale VH. The impact of perioperative music on abdominal surgery patients' experience of postoperative pain: A systematic review and meta-analysis. J Perioper Pract 2021; 31:31-43. [PMID: 32894995 DOI: 10.1177/1750458920943375] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Music interventions have been analysed for their use in many surgical specialties, but they have not yet been reviewed in relation to abdominal surgery. This systematic review and meta-analysis examines the effect that listening to music perioperatively has on the postoperative pain of abdominal surgery patients. METHODS A systematic search of PubMed, Cochrane Library and Scopus was undertaken to identify randomised controlled trials comparing a music intervention with standard care, where self-reported postoperative pain was included as an outcome. Study quality was then assessed by the author in conjunction with Robot Reviewer software based on the Cochrane bias methodology, and a meta-analysis was performed using standard mean difference and a random-effects model. RESULTS Twelve studies met the inclusion criteria for review, and eight studies (2217 subjects) had appropriate data reporting to be included in the meta-analysis. Half of the reviewed studies concluded a significant positive impact on postoperative pain and the meta-analysis reinforced this hypothesis (p < 0.001). There was minimal difference in impact between intra and postoperative interventions, or between patient or researcher selected music. CONCLUSIONS This review supports the use of music in the perioperative period for abdominal surgery patients as a low cost adjunct to pharmaceutical pain relief.
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Do ATL, Enax-Krumova EK, Özgül Ö, Eitner LB, Heba S, Tegenthoff M, Maier C, Höffken O. Distraction by a cognitive task has a higher impact on electrophysiological measures compared with conditioned pain modulation. BMC Neurosci 2020; 21:53. [PMID: 33287715 PMCID: PMC7720448 DOI: 10.1186/s12868-020-00604-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 11/23/2020] [Indexed: 12/23/2022] Open
Abstract
Background Conditioned pain modulation (CPM) evaluates the effect of a painful conditioning stimulus (CS) on a painful test stimulus (TS). Using painful cutaneous electrical stimulation (PCES) as TS and painful cold water as CS, the pain relief was paralleled by a decrease in evoked potentials (PCES-EPs). We now aimed to compare the effect of CPM with cognitive distraction on PCES-induced pain and PCES-EP amplitudes. Methods PCES was performed using surface electrodes inducing a painful sensation of 60 (NRS 0–100) on one hand. In a crossover design healthy subjects (included: n = 38, analyzed: n = 23) immersed the contralateral hand into 10 °C cold water (CS) for CPM evaluation and performed the 1-back task for cognitive distraction. Before and during the CS and 1-back task, respectively, subjects rated the pain intensity of PCES and simultaneously cortical evoked potentials were recorded. Results Both CPM and cognitive distraction significantly reduced PCES-EP amplitudes (CPM: 27.6 ± 12.0 μV to 20.2 ± 9.5 μV, cognitive distraction: 30.3 ± 14.2 µV to 13.6 ± 5.2 μV, p < 0.001) and PCES-induced pain (on a 0–100 numerical rating scale: CPM: 58 ± 4 to 41.1 ± 12.3, cognitive distraction: 58.3 ± 4.4 to 38.0 ± 13.0, p < 0.001), though the changes in pain intensity and PCES-amplitude did not correlate. The changes of the PCES-EP amplitudes during cognitive distraction were more pronounced than during CPM (p = 0.001). Conclusions CPM and cognitive distraction reduced the PCES-induced pain to a similar extent. The more pronounced decrease of PCES-EP amplitudes after distraction by a cognitive task implies that both conditions might not represent the general pain modulatory capacity of individuals, but may underlie different neuronal mechanisms with the final common pathway of perceived pain reduction.
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Affiliation(s)
- A T L Do
- Department of Neurology, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - E K Enax-Krumova
- Department of Neurology, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.
| | - Ö Özgül
- Department of Neurology, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - L B Eitner
- Department of Pain Medicine, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany.,Department of Neuropaediatrics, University Children's Hospital, Ruhr-University Bochum, Alexandrinenstraße 5, 44791, Bochum, Germany
| | - S Heba
- Department of Neurology, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | | | - C Maier
- Department of Pain Medicine, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - O Höffken
- Department of Neurology, Ruhr-University Bochum, BG University Hospital Bergmannsheil gGmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
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7
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Yu R, Zhuo Y, Feng E, Wang W, Lin W, Lin F, Li Z, Lin L, Xiao L, Wang H, Huang Y, Wu C, Zhang Y. The effect of musical interventions in improving short-term pain outcomes following total knee replacement: a meta-analysis and systematic review. J Orthop Surg Res 2020; 15:465. [PMID: 33036637 PMCID: PMC7547446 DOI: 10.1186/s13018-020-01995-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/01/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND A growing number of patients continue to receive total knee replacement (TKR) surgery. Nevertheless, such surgeries result in moderate to severe postoperative pain and difficulty in managing it. Musical interventions are regarded as a type of multimodal analgesia, achieving beneficial results in other clinical treatments. This study aims to evaluate the effect of musical interventions in improving short-term pain outcomes following TKR in order to determine a more reasonable and standard way of delivering musical intervention. METHODS A systematic search was conducted to identify available and relevant randomized controlled trials (RCTs) regarding musical interventions compared against non-musical interventions in patients treated with TKR in Embase, MEDLINE, Cochrane Library, Web of Science, CNKI, and Wanfang Med Online up to 8 January 2020. The authors independently assessed study eligibility and risk of bias and collected the outcomes of interest to analyze. The statistical analysis was conducted using the Review Manager (RevMan) version 5.30 software. RESULTS Eight RCTs comprised of 555 patients satisfied the inclusion criteria and were enrolled in the present study. The results showed no significant difference between the music and control groups in pain of the visual analog scale (VAS), during postoperative recovery room, back to the ward after surgery; anxiety degree of VAS; heart rate; respiratory rate; oxygen saturation; blood pressure, systolic blood pressure, and diastolic blood pressure. Nevertheless, significant differences were observed between the two groups in average increase in continuous passive motion (CPM) angles and LF/HF ratio (one kind index of heart rate variability). CONCLUSIONS Musical interventions fail to demonstrate an obvious effect in improving short-term pain outcomes following TKR. A reasonable standardization of musical interventions, including musical type, outcome measures used, outcomes measured, duration, timing and headphones or players, may improve pain outcomes with certain advantages and should be further explored after TKR.
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Affiliation(s)
- Rongguo Yu
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Youguang Zhuo
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Eryou Feng
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Wulian Wang
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Wentao Lin
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Feitai Lin
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Zhanglai Li
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Liqiong Lin
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Lili Xiao
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Haiyang Wang
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Yuting Huang
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Chunlin Wu
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China
| | - Yiyuan Zhang
- Department of Orthopedics, Fuzhou second Hospital Affiliated to Xiamen University, Fuzhou, 350007, Fujian, China.
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Sarquis-Kolber S, Schilling K, Hanney WJ, Kolber MJ. The Association of Mammography Environment and Image Quality. JOURNAL OF BREAST IMAGING 2020; 2:436-442. [PMID: 38424903 DOI: 10.1093/jbi/wbaa056] [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: 03/16/2020] [Indexed: 03/02/2024]
Abstract
OBJECTIVE This study sought to determine if a mammogram performed in a multi-sensory environmental upgraded room (UR) is associated with improved image quality when compared to a standard room (SR). METHODS A retrospective analysis (interrupted time series design) of compression force and posterior nipple line (PNL) measurements was performed on 303 women (mean age 60.9 years) who underwent screening mammography for 2 consecutive years (year 1 in SR, year 2 in UR) at a single outpatient facility. Using the Picture Archiving Communication System (PACS), craniocaudal (CC) and mediolateral oblique (MLO) images for the two years were reviewed. The PNL was measured for the CC and MLO images bilaterally using the embedded tools in the PACS software. Posterior nipple line and compression force were analyzed using a paired t-test. Bland-Altman plots were used to obtain 95% limits of agreement (LOA) between the UR and SR. RESULTS Image quality as determined by PNL measurement distance was greater in the UR (P < 0.001) when compared with the SR, with similar compression force (P ≥ 0.14). Mean PNL measurement differences ranged from 5.0 to 6.2 mm greater in the UR, whereas mean compression force differences ranged from -2.4 to 1.5 newtons. The 95% LOA suggest that PNL measurement differences between the UR and SR can vary by -11.0 to 27.0 mm. CONCLUSION Environmentally modifying mammography rooms may improve image quality with regard to PNL measurements without increasing compression force.
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Affiliation(s)
| | - Kathy Schilling
- Boca Raton Regional Hospital, Lynn Women's Health & Wellness Institute, Boca Raton, FL
| | - William J Hanney
- University of Central Florida, Division of Physical Therapy, Orlando, FL
| | - Morey J Kolber
- Nova Southeastern University, College of Health Care Sciences, Fort Lauderdale, FL
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Fan M, Chen Z. A systematic review of non-pharmacological interventions used for pain relief after orthopedic surgical procedures. Exp Ther Med 2020; 20:36. [PMID: 32952627 PMCID: PMC7480131 DOI: 10.3892/etm.2020.9163] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 07/21/2020] [Indexed: 02/07/2023] Open
Abstract
The purpose of the present review was to evaluate the available evidence on the efficacy of various non-pharmacological interventions to relieve pain after orthopedic surgical procedures. An electronic search of the PubMed, Embase and Cochrane library databases was performed to retrieve studies of all types assessing the role of non-pharmacological interventions for pain relief after orthopedic surgical procedures. The included studies were required to assess pain outcomes using a validated measurement index, such as the Visual Analog Scale. The quality of randomized control trials (RCTs) was assessed using the Cochrane tool, while the ROBINS-I tool was used for non-RCTs. A total of five studies were included, namely three RCTs and two non-RCTs. The included studies used relaxation therapy, guided imagery, music and audio-visual distraction for pain management. There was considerable heterogeneity concerning study participants and types of intervention, which precluded a meta-analysis. Overall, all studies reported a significant beneficial effect of non-pharmacological interventions for pain relief. To conclude, current evidence from a limited number of studies indicates there may be a potential role of non-pharmacological interventions, including relaxation therapy, guided imagery, music and audio-visual distraction, in pain management of patients after orthopedic surgery. Owing to considerable heterogeneity and risk of bias in the included studies, strong conclusions cannot be drawn. Further high-quality RCTs assessing the role of such non-pharmacological techniques of pain management are required to strengthen the current evidence.
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Affiliation(s)
- Meifen Fan
- Department of Operating Room, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, P.R. China
| | - Zheying Chen
- Department of Operating Room, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, P.R. China
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Nguyen BK, Svider PF, Hsueh WD, Folbe AJ. Perioperative Analgesia for Sinus and Skull-Base Surgery. Otolaryngol Clin North Am 2020; 53:789-802. [PMID: 32771245 DOI: 10.1016/j.otc.2020.05.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Perioperative analgesic management is multifaceted, and an individualized approach should be taken with each patient. Preoperative discussion of the plan for pain control and the patient's postoperative expectations is a necessary facet for optimal outcomes of analgesia. There is the potential for significant abuse and development of dependence on opioids. Nonopioids, such as nonsteroidal anti-inflammatory drugs, acetaminophen, and gabapentinoids, provide reliable alternatives for analgesic management following sinus and skull-base surgery. There is a paucity of literature regarding perioperative pain regimens for sinus and skull-base surgery, and the authors hope that this review serves as a valuable tool for otolaryngologists.
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Affiliation(s)
- Brandon K Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Peter F Svider
- Hackensack Meridian Health, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Wayne D Hsueh
- Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Adam J Folbe
- Department of Otolaryngology, William Beaumont Hospital, Royal Oak, MI, USA; Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
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Garland EL, Brintz CE, Hanley AW, Roseen EJ, Atchley RM, Gaylord SA, Faurot KR, Yaffe J, Fiander M, Keefe FJ. Mind-Body Therapies for Opioid-Treated Pain: A Systematic Review and Meta-analysis. JAMA Intern Med 2020; 180:91-105. [PMID: 31682676 PMCID: PMC6830441 DOI: 10.1001/jamainternmed.2019.4917] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/29/2019] [Indexed: 12/15/2022]
Abstract
Importance Mind-body therapies (MBTs) are emerging as potential tools for addressing the opioid crisis. Knowing whether mind-body therapies may benefit patients treated with opioids for acute, procedural, and chronic pain conditions may be useful for prescribers, payers, policy makers, and patients. Objective To evaluate the association of MBTs with pain and opioid dose reduction in a diverse adult population with clinical pain. Data Sources For this systematic review and meta-analysis, the MEDLINE, Embase, Emcare, CINAHL, PsycINFO, and Cochrane Library databases were searched for English-language randomized clinical trials and systematic reviews from date of inception to March 2018. Search logic included (pain OR analgesia OR opioids) AND mind-body therapies. The gray literature, ClinicalTrials.gov, and relevant bibliographies were also searched. Study Selection Randomized clinical trials that evaluated the use of MBTs for symptom management in adults also prescribed opioids for clinical pain. Data Extraction and Synthesis Independent reviewers screened citations, extracted data, and assessed risk of bias. Meta-analyses were conducted using standardized mean differences in pain and opioid dose to obtain aggregate estimates of effect size with 95% CIs. Main Outcomes and Measures The primary outcome was pain intensity. The secondary outcomes were opioid dose, opioid misuse, opioid craving, disability, or function. Results Of 4212 citations reviewed, 60 reports with 6404 participants were included in the meta-analysis. Overall, MBTs were associated with pain reduction (Cohen d = -0.51; 95% CI, -0.76 to -0.26) and reduced opioid dose (Cohen d = -0.26; 95% CI, -0.44 to -0.08). Studies tested meditation (n = 5), hypnosis (n = 25), relaxation (n = 14), guided imagery (n = 7), therapeutic suggestion (n = 6), and cognitive behavioral therapy (n = 7) interventions. Moderate to large effect size improvements in pain outcomes were found for meditation (Cohen d = -0.70), hypnosis (Cohen d = -0.54), suggestion (Cohen d = -0.68), and cognitive behavioral therapy (Cohen d = -0.43) but not for other MBTs. Although most meditation (n = 4 [80%]), cognitive-behavioral therapy (n = 4 [57%]), and hypnosis (n = 12 [63%]) studies found improved opioid-related outcomes, fewer studies of suggestion, guided imagery, and relaxation reported such improvements. Most MBT studies used active or placebo controls and were judged to be at low risk of bias. Conclusions and Relevance The findings suggest that MBTs are associated with moderate improvements in pain and small reductions in opioid dose and may be associated with therapeutic benefits for opioid-related problems, such as opioid craving and misuse. Future studies should carefully quantify opioid dosing variables to determine the association of mind-body therapies with opioid-related outcomes.
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Affiliation(s)
- Eric L. Garland
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City
- College of Social Work, University of Utah, Salt Lake City
| | - Carrie E. Brintz
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill
| | - Adam W. Hanley
- Center on Mindfulness and Integrative Health Intervention Development, University of Utah, Salt Lake City
- College of Social Work, University of Utah, Salt Lake City
| | - Eric J. Roseen
- Department of Family Medicine, Boston University and Boston University School of Medicine, Boston, Massachusetts
- Department of Rehabilitation Science, Massachusetts General Hospital Institute of Health Professions, Boston, Massachusetts
| | - Rachel M. Atchley
- Department of Anesthesiology, Brigham and Women’s Hospital, Harvard University, Boston, Massachusetts
| | - Susan A. Gaylord
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill
| | - Keturah R. Faurot
- Program on Integrative Medicine, Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill
| | - Joanne Yaffe
- College of Social Work, University of Utah, Salt Lake City
| | | | - Francis J. Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina
- Department of Anesthesiology, Duke University, Durham, North Carolina
- Department of Medicine, Duke University, Durham, North Carolina
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12
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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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Hasanpour-Dehkordi A, Solati K, Tali SS, Dayani MA. Effect of progressive muscle relaxation with analgesic on anxiety status and pain in surgical patients. ACTA ACUST UNITED AC 2019; 28:174-178. [DOI: 10.12968/bjon.2019.28.3.174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Ali Hasanpour-Dehkordi
- Associated Professor, Social Determinants of Health Research Center, School of Allied Medical Sciences
| | - Kamal Solati
- Associated Professor, Department of Medical Psychiatry
| | - Shahriar Salehi Tali
- Assistant Professor, Department of Medical-Surgical, Faculty of Nursing and Midwifery
| | - Mohamad Ali Dayani
- Assistant Professor, Department of Radiology All at Shahrekord University of Medical Sciences, Shahrekord, Iran
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14
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The Impact of Music Therapy in the Postoperative Setting on Overall Patient Satisfaction Using Validated Outcome Scores. J Perianesth Nurs 2018; 34:354-358. [PMID: 30025665 DOI: 10.1016/j.jopan.2018.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/09/2018] [Accepted: 04/14/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE Previous studies have examined music therapy (MT) as a potential modality to relieve negative postoperative symptoms such as pain. This randomized control trial examined the use of MT on patient satisfaction in the postanesthesia care unit. DESIGN Fifty patients undergoing outpatient orthopaedic surgery were enrolled and randomized into two groups, those receiving MT postoperatively and a control group who did not. METHODS After hospital discharge, subjects were assessed with two validated outcome measurements for overall patient satisfaction, the visual analog satisfaction scale and the Patient Judgment of Hospital Quality survey. FINDINGS The results showed no statistically significant differences between the MT and control group on the Patient Judgment of Hospital Quality survey (MT = 3.42, standard therapy = 3.41, P = .94) and the visual analog satisfaction scale (MT = 91.20, standard therapy = 91.65, P = .88). CONCLUSIONS MT given in the postoperative setting has no impact on overall patient satisfaction.
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Kühlmann AYR, de Rooij A, Kroese LF, van Dijk M, Hunink MGM, Jeekel J. Meta-analysis evaluating music interventions for anxiety and pain in surgery. Br J Surg 2018; 105:773-783. [PMID: 29665028 PMCID: PMC6175460 DOI: 10.1002/bjs.10853] [Citation(s) in RCA: 162] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/08/2017] [Accepted: 02/09/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study aimed to evaluate anxiety and pain following perioperative music interventions compared with control conditions in adult patients. METHODS Eleven electronic databases were searched for full-text publications of RCTs investigating the effect of music interventions on anxiety and pain during invasive surgery published between 1 January 1980 and 20 October 2016. Results and data were double-screened and extracted independently. Random-effects meta-analysis was used to calculate effect sizes as standardized mean differences (MDs). Heterogeneity was investigated in subgroup analyses and metaregression analyses. The review was registered in the PROSPERO database as CRD42016024921. RESULTS Ninety-two RCTs (7385 patients) were included in the systematic review, of which 81 were included in the meta-analysis. Music interventions significantly decreased anxiety (MD -0·69, 95 per cent c.i. -0·88 to -0·50; P < 0·001) and pain (MD -0·50, -0·66 to -0·34; P < 0·001) compared with controls, equivalent to a decrease of 21 mm for anxiety and 10 mm for pain on a 100-mm visual analogue scale. Changes in outcome corrected for baseline were even larger: MD -1·41 (-1·89 to -0·94; P < 0·001) for anxiety and -0·54 (-0·93 to -0·15; P = 0·006) for pain. Music interventions provided during general anaesthesia significantly decreased pain compared with that in controls (MD -0·41, -0·64 to -0·18; P < 0·001). Metaregression analysis found no significant association between the effect of music interventions and age, sex, choice and timing of music, and type of anaesthesia. Risk of bias in the studies was moderate to high. CONCLUSION Music interventions significantly reduce anxiety and pain in adult surgical patients.
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Affiliation(s)
- A Y R Kühlmann
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - A de Rooij
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - L F Kroese
- Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M van Dijk
- Department of Paediatric Surgery, Erasmus Medical Centre-Sophia Children's Hospital, Rotterdam, The Netherlands.,Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M G M Hunink
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - J Jeekel
- Department of Neuroscience, Erasmus Medical Centre, Rotterdam, The Netherlands
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Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S. Psychological interventions for acute pain after open heart surgery. Cochrane Database Syst Rev 2017; 7:CD009984. [PMID: 28701028 PMCID: PMC6432747 DOI: 10.1002/14651858.cd009984.pub3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation. SEARCH METHODS For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, and PsycINFO for eligible studies up to February 2017. We used the 'related articles' and 'cited by' options of eligible studies to identify additional relevant studies. We checked lists of references of relevant articles and previous reviews. We searched the ProQuest Dissertations and Theses Full Text Database, ClinicalTrials and the WHO International Clinical Trials Registry Platform to identify any unpublished material or ongoing trials. We also contacted the authors of primary studies to identify any unpublished material. In addition, we wrote to all leading heart centres in Germany, Switzerland, and Austria to check whether they were aware of any ongoing trials. SELECTION CRITERIA Randomised controlled trials comparing psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery. DATA COLLECTION AND ANALYSIS Two review authors (SZ and SK) independently assessed trials for eligibility, estimated the risk of bias and extracted all data. We calculated effect sizes for each comparison (Hedges' g) and meta-analysed data using a random-effects model. We assessed the evidence using GRADE and created 'Summary of findings' tables. MAIN RESULTS We added six studies to this update. Overall, we included 23 studies (2669 participants).For the majority of outcomes (two-thirds), we could not perform a meta-analysis since outcomes were not measured, or data were provided by one trial only.No study reported data on the number of participants with pain intensity reduction of at least 50% from baseline. Only one study reported data on the number of participants below 30/100 mm on the Visual Analogue Scale (VAS) in pain intensity (very low-quality evidence). Psychological interventions did not reduce pain intensity in the short-term interval (g 0.39, 95% CI -0.18 to 0.96, 2 studies, 104 participants, low-quality evidence), medium-term interval (g -0.02, 95% CI -0.24 to 0.20, 4 studies, 413 participants, moderate-quality evidence) or in the long-term interval (g 0.05, 95% CI -0.20 to 0.30, 2 studies, 200 participants, moderate-quality evidence).No study reported data on median time to re-medication or on number of participants re-medicated. Only two studies provided data on postoperative analgesic use in the short-term interval, showing that psychological interventions did not reduce the use of analgesic medication (g 1.18, 95% CI -2.03 to 4.39, 2 studies, 104 participants, low-quality evidence). Studies revealed that psychological interventions reduced mental distress in the medium-term (g 0.37, 95% CI 0.13 to 0.60, 13 studies, 1388 participants, moderate-quality evidence) and likewise in the long-term interval (g 0.32, 95% CI 0.10 to 0.53, 14 studies, 1586 participants, moderate-quality evidence). Psychological interventions did not improve mobility in the medium-term interval (g 0.23, 95% CI -0.22 to 0.67, 3 studies, 444 participants, low-quality evidence), nor in the long-term interval (g 0.09, 95% CI -0.10 to 0.28, 4 studies, 458 participants, moderate-quality evidence). Only two studies reported data on time to extubation, indicating that psychological interventions reduced the time to extubation (g 0.56, 95% CI 0.08 to 1.03, 2 studies, 154 participants, low-quality evidence).Overall, the very low to moderate quality of the body of evidence on the efficacy of psychological interventions for acute pain after open heart surgery cannot be regarded as sufficient to draw robust conclusions.Most 'Risk of bias' assessments were low or unclear. We judged selection bias (random sequence generation) and attrition bias to be mostly low risk for included studies. However, we judged the risk of selection bias (allocation concealment), performance bias, detection bias and reporting bias to be mostly unclear. AUTHORS' CONCLUSIONS In line with the conclusions of our previous review, there is a lack of evidence to support or refute psychological interventions in order to reduce postoperative pain in participants undergoing open heart surgery. We found moderate-quality evidence that psychological interventions reduced mental distress in participants undergoing open heart surgery. Given the small numbers of studies, it is not possible to draw robust conclusions on the efficacy of psychological interventions on outcomes such as analgesic use, mobility, and time to extubation respectively on adverse events or harms of psychological interventions.
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Affiliation(s)
- Susanne Ziehm
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Jenny Rosendahl
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Jürgen Barth
- UniversityHospital and University of ZurichInstitute for Complementary and Integrative MedicineSonneggstrasse 6ZurichSwitzerlandCH‐8091
| | - Bernhard M Strauss
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Anja Mehnert
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Susan Koranyi
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
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Cornelius R, Herr KA, Gordon DB, Kretzer K, Butcher HK. Evidence-Based Practice Guideline : Acute Pain Management in Older Adults. J Gerontol Nurs 2017; 43:18-27. [DOI: 10.3928/00989134-20170111-08] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Chen Q, Zhang Y, Hou H, Du F, Wu S, Chen L, Shen Y, Chao F, Chung JK, Zhang H, Tian M. Neural correlates of the popular music phenomenon: evidence from functional MRI and PET imaging. Eur J Nucl Med Mol Imaging 2017; 44:1033-1041. [PMID: 28083689 DOI: 10.1007/s00259-017-3614-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 01/02/2017] [Indexed: 01/25/2023]
Abstract
PURPOSE Music can induce different emotions. However, its neural mechanism remains unknown. The aim of this study was to use functional magnetic resonance imaging (fMRI) and position emission tomography (PET) imaging for mapping of neural changes under the most popular music in healthy volunteers. METHODS Blood-oxygen-level-dependent (BOLD) fMRI and monoamine receptor PET imaging with 11C-N-methylspiperone (11C-NMSP) were conducted under the popular music Gangnam Style and light music A Comme Amour in healthy subjects. PET and fMRI images were analyzed by using the Statistical Parametric Mapping software (SPM). RESULTS Significantly increased fMRI BOLD signals were found in the bilateral superior temporal cortices, left cerebellum, left putamen and right thalamus cortex. Monoamine receptor availability was increased significantly in the left superior temporal gyrus and left putamen, but decreased in the bilateral superior occipital cortices under the Gangnam Style compared with the light music condition. Significant positive correlation was found between 11C-NMSP binding and fMRI BOLD signals in the left temporal cortex. Furthermore, increased 11C-NMSP binding in the left putamen was positively correlated with the mood arousal level score under the Gangnam Style condition. CONCLUSION Popular music Gangnam Style can arouse pleasure experience and strong emotional response. The left putamen is positively correlated with the mood arousal level score under the Gangnam Style condition. Our results revealed characteristic patterns of brain activity associated with Gangnam Style, and may also provide more general insights into the music-induced emotional processing.
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Affiliation(s)
- Qiaozhen Chen
- Department of Psychiatry, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Ying Zhang
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Haifeng Hou
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Fenglei Du
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Shuang Wu
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Lin Chen
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Yehua Shen
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Fangfang Chao
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - June-Key Chung
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Hong Zhang
- Zhejiang University Medical PET Center, Hangzhou, China
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China
| | - Mei Tian
- Zhejiang University Medical PET Center, Hangzhou, China.
- Institute of Nuclear Medicine and Molecular Imaging of Zhejiang University, Hangzhou, China.
- Key Laboratory of Medical Molecular Imaging of Zhejiang Province, Hangzhou, China.
- Department of Nuclear Medicine, The Second Affiliated Hospital of Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang, 310009, China.
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Management of Postoperative Pain: A Clinical Practice Guideline From the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists' Committee on Regional Anesthesia, Executive Committee, and Administrative Council. THE JOURNAL OF PAIN 2016; 17:131-57. [PMID: 26827847 DOI: 10.1016/j.jpain.2015.12.008] [Citation(s) in RCA: 1598] [Impact Index Per Article: 199.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 12/11/2015] [Accepted: 12/14/2015] [Indexed: 12/11/2022]
Abstract
UNLABELLED Most patients who undergo surgical procedures experience acute postoperative pain, but evidence suggests that less than half report adequate postoperative pain relief. Many preoperative, intraoperative, and postoperative interventions and management strategies are available for reducing and managing postoperative pain. The American Pain Society, with input from the American Society of Anesthesiologists, commissioned an interdisciplinary expert panel to develop a clinical practice guideline to promote evidence-based, effective, and safer postoperative pain management in children and adults. The guideline was subsequently approved by the American Society for Regional Anesthesia. As part of the guideline development process, a systematic review was commissioned on various aspects related to various interventions and management strategies for postoperative pain. After a review of the evidence, the expert panel formulated recommendations that addressed various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. The recommendations are based on the underlying premise that optimal management begins in the preoperative period with an assessment of the patient and development of a plan of care tailored to the individual and the surgical procedure involved. The panel found that evidence supports the use of multimodal regimens in many situations, although the exact components of effective multimodal care will vary depending on the patient, setting, and surgical procedure. Although these guidelines are based on a systematic review of the evidence on management of postoperative pain, the panel identified numerous research gaps. Of 32 recommendations, 4 were assessed as being supported by high-quality evidence, and 11 (in the areas of patient education and perioperative planning, patient assessment, organizational structures and policies, and transitioning to outpatient care) were made on the basis of low-quality evidence. PERSPECTIVE This guideline, on the basis of a systematic review of the evidence on postoperative pain management, provides recommendations developed by a multidisciplinary expert panel. Safe and effective postoperative pain management should be on the basis of a plan of care tailored to the individual and the surgical procedure involved, and multimodal regimens are recommended in many situations.
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Lee JH. The Effects of Music on Pain: A Meta-Analysis. J Music Ther 2016; 53:430-477. [PMID: 27760797 DOI: 10.1093/jmt/thw012] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 09/18/2016] [Accepted: 09/19/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Numerous meta-analyses have been conducted on the topic of music and pain, with the latest comprehensive study published in 2006. Since that time, more than 70 randomized controlled trials (RCTs) have been published, necessitating a new and comprehensive review. OBJECTIVE The aim of this meta-analysis was to examine published RCT studies investigating the effect of music on pain. METHODS The present study included RCTs published between 1995 and 2014. Studies were obtained by searching 12 databases and hand-searching related journals and reference lists. Main outcomes were pain intensity, emotional distress from pain, vital signs, and amount of analgesic intake. Study quality was evaluated according to the Cochrane Collaboration guidelines. RESULTS Analysis of the 97 included studies revealed that music interventions had statistically significant effects in decreasing pain on 0-10 pain scales (MD = -1.13), other pain scales (SMD = -0.39), emotional distress from pain (MD = -10.83), anesthetic use (SMD = -0.56), opioid intake (SMD = -0.24), non-opioid intake (SMD = -0.54), heart rate (MD = -4.25), systolic blood pressure (MD = -3.34), diastolic blood pressure (MD = -1.18), and respiration rate (MD = -1.46). Subgroup and moderator analyses yielded additional clinically informative outcomes. CONCLUSIONS Considering all the possible benefits, music interventions may provide an effective complementary approach for the relief of acute, procedural, and cancer/chronic pain in the medical setting.
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Herr KA, Kwekkeboom KL. Assisting Older Clients With Pain Management in the Home. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822302250693] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Older home health clients experience significant pain from a variety of age-related conditions. It is important for home health nurses to be knowledgeable about strategies for assessing and managing pain that are adapted to the unique needs of the older patient. A thorough pain assessment gathers key information guiding treatment decisions and follow-up evaluation of intervention effectiveness. Nonpharmacologic interventions, including comfort measures, cutaneous stimulation techniques, and cognitive-behavioral strategies, may help to relieve mild pain when used alone and moderate to severe pain when used in addition to analgesic medications. Assessment and treatment strategies can be tailored to meet the needs of the older clients, taking into account the clients’ cognitive ability and caregivers’ willingness to participate. Home health nurses, in their limited contact time, can educate both older clients and family caregivers in actively managing pain through frequent pain assessment and the use of nonpharmacologic interventions.
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Guétin S, Diego ED, Mohy F, Adolphe C, Hoareau G, Touchon J, Thayer JF, Koenig J. A patient-controlled, smartphone-based music intervention to reduce pain—A multi-center observational study of patients with chronic pain. Eur J Integr Med 2016. [DOI: 10.1016/j.eujim.2016.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Archana R, Mukilan R. Beneficial Effect of Preferential Music on Exercise Induced Changes in Heart Rate Variability. J Clin Diagn Res 2016; 10:CC09-11. [PMID: 27437208 DOI: 10.7860/jcdr/2016/18320.7740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 03/15/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Music is known to reduce pain, anxiety and fear in several stressful conditions in both males and females. Further, listening to preferred music enhances the endurance during running performance of women rather than listening to non-preferred music. In recent years Heart Rate Variability (HRV) has been used as an indicator of autonomic nervous activity. AIM This study was aimed to assess the effectiveness of preferential music on HRV after moderate exercise. MATERIALS AND METHODS This was an experimental study done in 30 healthy students aged between 20-25 years, of either sex. HRV was measured at rest, 15 minutes of exercise only and 15 minutes of exercise with listening preferential music in same participants. Data was analysed by One-Way ANOVA and Tukey HSD Post-hoc Test. Statistical significance was taken to be a p-value of less than 0.05. RESULTS Low frequency and high frequency component was significantly increased followed by only exercise. Music minimized increase in both high and low frequency component followed by exercise. However, only high frequency change was statistically significant. LF/HF ratio was significantly increased followed by only exercise. Music significantly minimized increase in LF/HF ratio. CONCLUSION This study provides the preliminary evidence that listening to preferential music could be an effective method of relaxation, as indicated by a shift of the autonomic balance towards the parasympathetic activity among medical students.
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Affiliation(s)
- R Archana
- Professor, Department of Physiology, Saveetha Medical College , Chennai, Tamil Nadu, India
| | - R Mukilan
- Senior Lecturer, Department of Physiology, CSI College of Dental Sciences and Research , Madurai, Tamil Nadu, India
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Abstract
Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the underlying mechanisms of the psychological and physiological responses to music have been poorly identified and defined. Without clarification, a concept can be misused, thereby diminishing its importance for application to nursing research and practice. The purpose of this article was for the clarification of the concept of music therapy based on Walker and Avant’s concept analysis strategy. A review of recent nursing and health-related literature covering the years 2007–2014 was performed on the concepts of music, music therapy, preferred music, and individualized music. As a result of the search, the attributes, antecedents, and consequences of music therapy were identified, defined, and used to develop a conceptual model of music therapy. The conceptual model of music therapy provides direction for developing music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avant’s concept analysis strategy, model and contrary cases are included. Implications for future nursing research and practice to use the psychological and physiological responses to music therapy are discussed.
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Abstract
OBJECTIVES Psychological interventions administered before wounding can reduce stress and improve healing. However, in many cases, it would be more practical for interventions to be delivered after wounding. This preliminary study investigated whether a brief relaxation intervention could improve healing when administered either before or after skin damage produced by tape stripping in comparison to a control group. METHODS One hundred twenty-one healthy adults were randomized into one of three groups: (a) relaxation prestripping group, (b) relaxation poststripping group, or (c) no relaxation. Participants completed measures of stress, fatigue, relaxation, and pain. Relaxation consisted of listening to 20 minutes of guided relaxation, whereas the control condition was quiet reading for 20 minutes. Skin barrier function was measured using transepidermal water loss at baseline, immediately after tape stripping and 25 minutes later. RESULTS Relaxation either before or after tape stripping improved skin barrier recovery compared with the control group (F(2,92) = 3.58, p = .032, partial η = 0.074). Participants who took part in the relaxation intervention were significantly more relaxed and reported greater reductions in pain than the control group did 25 minutes after tape stripping. Perceived stress over the last month was not significantly related to healing. CONCLUSIONS This study showed that a relaxation intervention had a beneficial effect on skin barrier recovery regardless of whether the intervention was administered before or after wounding. Future research needs to replicate these findings in other wound types and in clinical settings, and investigate the biological mechanisms involved.
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Liu Y, Petrini MA. Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery. Complement Ther Med 2015; 23:714-8. [PMID: 26365452 DOI: 10.1016/j.ctim.2015.08.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 07/15/2015] [Accepted: 08/01/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To examine the effectiveness of music listening on pain, anxiety, and vital signs among patients after thoracic surgery in China. DESIGN AND SETTING A randomized controlled clinical trial was conducted in the thoracic surgery department of two tertiary hospitals in Wuhan, China. 112 patients were recruited and randomly assigned to either experimental (n=56) or control (n=56) group respectively. INTERVENTION The experimental group received standard care and a 30-min soft music intervention for 3 days, while the control group received only standard care. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate), patient controlled analgesia, and diclofenac sodium suppository use. RESULTS The experimental group showed statistically significant decrease in pain, anxiety, systolic blood pressure and heart rate over time compared to the control group, but no significant difference were identified in diastolic blood pressure, respiratory rate, patient controlled analgesia and diclofenac sodium suppository use. CONCLUSION The findings provide further evidence to support the practice of music therapy to reduce postoperative pain and anxiety, and lower systolic blood pressure and heart rate in patients after thoracic surgery in China.
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Affiliation(s)
- Yang Liu
- HOPE School of Nursing, Wuhan University, Wuhan, China.
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Developing a context appropriate clinical guideline for post-operative pain management in Ghana: A participatory approach. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2015. [DOI: 10.1016/j.ijans.2015.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Rafii F, Mohammadi-Fakhar F, Jamshidi Orak R. Effectiveness of Jaw Relaxation for Burn Dressing Pain: Randomized Clinical Trial. Pain Manag Nurs 2014; 15:845-53. [DOI: 10.1016/j.pmn.2013.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 10/29/2013] [Accepted: 11/12/2013] [Indexed: 11/25/2022]
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Koranyi S, Barth J, Trelle S, Strauss BM, Rosendahl J. Psychological interventions for acute pain after open heart surgery. Cochrane Database Syst Rev 2014:CD009984. [PMID: 24861376 DOI: 10.1002/14651858.cd009984.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery on pain, pain medication, mental distress, mobility, and time to extubation. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE (1946 to September 2013), EMBASE (1980 to September 2013), Web of Science (all years to September 2013), and PsycINFO (all years to September 2013) for eligible studies. We used the 'related articles' and 'cited by' options of eligible studies to identify additional relevant studies. We also checked lists of references of relevant articles and previous reviews. We also searched the ProQuest Dissertations and Theses Full Text Database (all years to September 2013) and contacted the authors of primary studies to identify any unpublished material. SELECTION CRITERIA Randomised controlled trials comparing psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery. DATA COLLECTION AND ANALYSIS Two review authors (SK and JR) independently assessed trials for eligibility, estimated the risk of bias and extracted all data. We calculated effect sizes for each comparison (Hedges' g) and meta-analysed data using a random-effects model. MAIN RESULTS Nineteen trials were included (2164 participants).No study reported data on the number of participants with pain intensity reduction of at least 50% from baseline. Only one study reported data on the number of participants below 30/100 mm on the Visual Analogue Scale (VAS) in pain intensity. Psychological interventions have no beneficial effects in reducing pain intensity measured with continuous scales in the medium-term interval (g -0.02, 95% CI -0.24 to 0.20, 4 studies, 413 participants, moderate quality evidence) nor in the long-term interval (g 0.12, 95% CI -0.09 to 0.33, 3 studies, 280 participants, low quality evidence).No study reported data on median time to remedication or on number of participants remedicated. Only one study provided data on postoperative analgesic use. Studies reporting data on mental distress in the medium-term interval revealed a small beneficial effect of psychological interventions (g 0.36, 95% CI 0.10 to 0.62, 12 studies, 1144 participants, low quality evidence). Likewise, a small beneficial effect of psychological interventions on mental distress was obtained in the long-term interval (g 0.28, 95% CI 0.05 to 0.51, 11 studies, 1320 participants, low quality evidence). There were no beneficial effects of psychological interventions on mobility in the medium-term interval (g 0.23, 95% CI -0.22 to 0.67, 3 studies, 444 participants, low quality evidence) nor in the long-term interval (g 0.29, 95% CI -0.14 to 0.71, 4 studies, 423 participants, low quality evidence). Only one study reported data on time to extubation. AUTHORS' CONCLUSIONS For the majority of outcomes (two-thirds) we could not perform a meta-analysis since outcomes were not measured, or data were provided by one trial only. Psychological interventions have no beneficial effects on reducing postoperative pain intensity or enhancing mobility. There is low quality evidence that psychological interventions reduce postoperative mental distress. Due to limitations in methodological quality, a small number of studies, and large heterogeneity, we rated the quality of the body of evidence as low. Future trials should measure crucial outcomes (e.g. number of participants with pain intensity reduction of at least 50% from baseline) and should focus to enhance the quality of the body of evidence in general. Altogether, the current evidence does not clearly support the use of psychological interventions to reduce pain in participants undergoing open heart surgery.
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Affiliation(s)
- Susan Koranyi
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital of Jena, Stoystrasse 3, Jena, Thuringia, Germany, 07743
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Abbaspoor Z, Akbari M, Najar S. Effect of Foot and Hand Massage In Post–Cesarean Section Pain Control: A Randomized Control Trial. Pain Manag Nurs 2014; 15:132-6. [DOI: 10.1016/j.pmn.2012.07.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2011] [Revised: 07/16/2012] [Accepted: 07/25/2012] [Indexed: 10/27/2022]
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Mogos MF, Angard N, Goldstein L, Beckstead JW. The effects of live therapeutic music on patient's affect and perceptions of care: A randomized field study. Complement Ther Clin Pract 2013; 19:188-92. [DOI: 10.1016/j.ctcp.2013.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 07/19/2013] [Accepted: 07/30/2013] [Indexed: 11/24/2022]
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Abstract
2011: this review is being updated by a new author team who are preparing a new protocol. This update is due to be published in 2011. The replacement protocol was published in September 2011 (Bradshaw DH, Brown CJ, Cepeda MS, Pace NL. Music for pain relief (Protocol). Cochrane Database of Systematic Reviews 2011, Issue 9. Art. No.: CD009284. DOI: 10.1002/14651858.CD009284). 2015: at July 2015, the PaPaS Review Group withdrew the 2011 protocol (Bradshaw 2011) as there were significant delays in preparing the full review, which did not meet the expectations of Cochrane and PaPaS editorial processes and timelines. For more information, please contact the PaPaS CRG office. The editorial group responsible for this previously published document have withdrawn it from publication.
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Affiliation(s)
- M Soledad Cepeda
- Johnson & Johnson Pharmaceutical Research and DevelopmentPharmacoepidemiologyPO BOX 200, M/S K304TitussvilleNJUSA08560
| | - Daniel B Carr
- Tufts University School of MedicineDepartment of Public Health and Community Medicine136 Harrison Avenue, Stearns 203CBostonUSA
| | - Joseph Lau
- Brown University Public Health ProgramCenter for Evidence‐based Medicine121 S. Main StreetProvidenceRIUSA02912
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Crowe L, Chang A, Fraser JA, Gaskill D, Nash R, Wallace K. Systematic review of the effectiveness of nursing interventions in reducing or relieving post-operative pain. INT J EVID-BASED HEA 2013; 6:396-430. [PMID: 21631835 DOI: 10.1111/j.1744-1609.2008.00113.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives The primary objective of this systematic review was to assess the effectiveness of nursing interventions for the relief/reduction of post-operative pain when compared with either standard care or other nursing interventions. Inclusion criteria Types of studies This review included randomised controlled trials (RCTs) and other quasi-randomised experimental research designs. Types of participants Adults treated for post-operative pain in an acute care hospital. Types of interventions Interventions included in the review were only those directly administered by nursing staff such as: (i) administration of analgesia: including oral, intramuscular injection, patient controlled analgesia, epidural; (ii) pre-operative patient education; (iii) assessment and documentation of intensity of pain at regular intervals; (iv) protocols, clinical pathways or flow-sheets used in the management of pain; and (v) non-pharmacological interventions such as massage and relaxation. Types of outcome measures The primary outcome was the relief or reduction of post-operative pain. Other measures included analgesia consumption, patient satisfaction and length of hospital stay. Search strategy Search terms were chosen after reviewing text words and MeSH terms in relevant articles and databases. A search for published and unpublished research covering the period 1985-2004 (inclusive) was conducted, using 11 major electronic databases. Reference lists of retrieved articles were hand searched. The search was restricted to reports published in English. Assessment of quality The methodological quality of eligible studies was appraised by two independent reviewers, using a standardised critical appraisal tool. Differences in opinion were decided by consensus after discussion with a third investigator. Data extraction and analysis Data were extracted from the studies that met the criteria for methodological quality. Two reviewers independently extracted data for each study, using a standardised extraction tool. Results from homogeneous RCTs where possible were pooled in meta-analysis using RevMan4.2 software program. If the studies were clinically or statistically heterogeneous, the results are discussed in a narrative form. Non-randomised studies are also discussed in narrative form. Results Overall, there is no strong evidence to support the use of any intervention even though a few interventions showed some benefits. However, evidence for these benefits was often based on single studies. Most of the included studies showed that there was no difference between the interventions and the usual care with both being found equally effective. Implications for practice There was no strong evidence to support a particular practice. No intervention was found to be harmful; however, this does not presume to be evidence of safety. When there are two similarly effective interventions nurses need to weigh the possible positive and negative of the intervention including side effects, risk of adverse events, cost and patient preference. Other considerations include variations in patients' past pain experiences, type of surgery, many different analgesics. Although there were no controlled trials to support assessment and documentation, professionally and legally, documentation is required.
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Affiliation(s)
- Linda Crowe
- The Queensland Centre for Evidence Based Nursing and Midwifery Practice: a collaborating centre of The Joanna Briggs Institute, and Nursing Research Centre, Mater Health Services, South Brisbane and School of Nursing, Queensland University of Technology, Kelvin Grove, Queensland, Australia
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Onieva-Zafra MD, Castro-Sánchez AM, Matarán-Peñarrocha GA, Moreno-Lorenzo C. Effect of Music as Nursing Intervention for People Diagnosed with Fibromyalgia. Pain Manag Nurs 2013; 14:e39-46. [DOI: 10.1016/j.pmn.2010.09.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Revised: 09/24/2010] [Accepted: 09/24/2010] [Indexed: 12/01/2022]
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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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Predictors of Acute Postsurgical Pain and Anxiety Following Primary Total Hip and Knee Arthroplasty. THE JOURNAL OF PAIN 2013; 14:502-15. [DOI: 10.1016/j.jpain.2012.12.020] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Revised: 12/15/2012] [Accepted: 12/31/2012] [Indexed: 11/20/2022]
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The effects of relaxation breathing on procedural pain and anxiety during burn care. Burns 2013; 39:1101-6. [PMID: 23375536 DOI: 10.1016/j.burns.2013.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/27/2012] [Accepted: 01/04/2013] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Burn patients experience high levels of pain and anxiety during dressing changes. Relaxation breathing is a simple behavioral intervention to manage pain and anxiety. However, the information about the effects of relaxation breathing on pain and anxiety levels for burn patients during dressing changes is limited. METHODS This study followed a quasi-experimental, pretest-posttest comparison group design without random assignment to groups. A total of 64 burn patients from Daejeon, South Korea were recruited by a convenience sequential sampling approach. With institutional approval and written consent, the experimental group practiced relaxation breathing during dressing change procedures. Data were collected from June to September 2011 using a VAS for pain and a VAS-A for anxiety. RESULTS The homogeneity test was used to detect any significant group differences in the demographic data and pretest measures. The pain scores significantly differed between the 2 groups after intervention (RB group vs. control group, P=.01) and over time (pretest vs. posttest, P=.001). The anxiety scores significantly differed between the 2 groups (P=.01) and over time (P=.02). CONCLUSION Relaxation breathing is a simple and inexpensive technique nurses can use to help burn patients manage pain and anxiety during dressing changes.
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Mohammadi Fakhar F, Rafii F, Jamshidi Orak R. The effect of jaw relaxation on pain anxiety during burn dressings: Randomised clinical trial. Burns 2013; 39:61-7. [DOI: 10.1016/j.burns.2012.03.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 03/10/2012] [Accepted: 03/16/2012] [Indexed: 11/16/2022]
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Risk factors for persistent postsurgical pain in women undergoing hysterectomy due to benign causes: a prospective predictive study. THE JOURNAL OF PAIN 2012; 13:1045-57. [PMID: 23063345 DOI: 10.1016/j.jpain.2012.07.014] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2012] [Revised: 07/15/2012] [Accepted: 07/25/2012] [Indexed: 11/23/2022]
Abstract
UNLABELLED Persistent postsurgical pain (PPSP) is a major clinical problem with significant individual, social, and healthcare costs. The aim of this study was to examine the role of demographic, clinical, and psychological risk factors in the development of PPSP after hysterectomy due to benign disorders. In a prospective study, a consecutive sample of 186 women was assessed 24 hours before surgery (T1), 48 hours after surgery (T2), and 4 months after surgery (T3). Regression analyses were performed to identify predictors of PPSP. Four months after hysterectomy, 93 (50%) participants reported experiencing pain (numerical rating scale >0). Age, pain due to other causes, and type of hysterectomy emerged as significant predictive factors. Baseline presurgical psychological predictors identified were anxiety, emotional illness representation of the condition leading to surgery, and pain catastrophizing. Among the identified psychological predictors, emotional illness representation emerged as the strongest. Acute postsurgical pain frequency and postsurgical anxiety also revealed a predictive role in PPSP development. These results increase the knowledge on PPSP predictors and point healthcare professionals toward specific intervention targets such as anxiety (presurgical and postsurgical), pain catastrophizing, emotional illness representations, and acute pain control after surgery. PERSPECTIVE This study found that presurgical anxiety, emotional illness representations, and pain catastrophizing are risk factors for PPSP 4 months after hysterectomy, over and above age and clinical variables. These findings improve knowledge on PPSP and highlight potential intervention targets for healthcare professionals.
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Tefikow S, Barth J, Trelle S, Strauss BM, Rosendahl J. Psychological interventions for acute pain after open heart surgery. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wang J, Jian F, Chen J, Ye NS, Huang YH, Wang S, Huang RH, Pei J, Liu P, Zhang L, Zhao ZH, Chen QM, Lai WL, Lin YF. Cognitive behavioral therapy for orthodontic pain control: a randomized trial. J Dent Res 2012; 91:580-5. [PMID: 22492277 DOI: 10.1177/0022034512444446] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The objective of this study was to evaluate the efficacy of cognitive behavioral therapy intervention for patients who experienced pain during orthodontic treatment. The baseline characteristics were assessed via questionnaires and oral examinations. Four hundred and fifty eligible individuals were recruited and randomized by computer-generated block randomization into three groups: cognitive behavioral therapy intervention (n = 150), ibuprofen intervention (n = 150), and no intervention (control; n = 150). Primary outcomes were the change from baseline in pain intensity measured with 100-mm Visual Analog Scale (VAS) scores at 1, 2, 3, 7, 14, and 30 days after initial archwire placement. Outcomes assessment was blinded and followed the intention-to-treat principle. One hundred forty-three (95.30%), 145 (96.70%), and 141 (94.00%) individuals in the cognitive behavioral therapy, the ibuprofen, and the control groups, respectively, completed the one-month follow-up evaluations. Those in the cognitive behavioral therapy group showed a greater decrease in mean VAS scores than did those in the control group over the previous five time-points (p < 0.001). Cognitive behavioral therapy was shown to be effective in pain control during the initial stage of orthodontic treatment. The study registration number was ChiCTR-TRC-00000556.
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Affiliation(s)
- J Wang
- State Key Laboratory of Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, P.R. China
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Good M, Albert JM, Arafah B, Anderson GC, Wotman S, Cong X, Lane D, Ahn S. Effects on postoperative salivary cortisol of relaxation/music and patient teaching about pain management. Biol Res Nurs 2012; 15:318-29. [PMID: 22472905 DOI: 10.1177/1099800411431301] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The physiological and psychological stress of surgery and postoperative pain can leave patients more susceptible to infection and complications. The present study was designed to determine whether two interventions, patient teaching (PT) for pain management and relaxation/music (RM), reduced cortisol levels, an indicator of stress, following abdominal surgery. Patients (18-75 years) were randomly assigned to receive PT, RM, a combination of the two, or usual care; the 205 patients with both pre- and posttest cortisol values were analyzed. A 2 × 2 factorial design was used to compare groups for PT effects and RM effects. Stress was measured by salivary cortisol before and after 20-min tests of the interventions in the morning and afternoon of postoperative Day 2. Saliva was stimulated with lemon juice and analyzed with high-sensitivity salivary cortisol enzyme immunoassay. Comparisons using analysis of covariance (ANCOVA), controlling for baseline levels, showed no PT effect or RM effect on cortisol in the morning or afternoon. Post hoc ANCOVA showed no significant effects when intervention groups were compared to the control group. Although in previous studies, RM reduced pain and music reduced cortisol on Day 1, in the present study the cortisol response to surgery was not attenuated by PT or RM on Day 2. The RM intervention can be used for pain but needs to be further tested for effects on plasma cortisol in abdominal surgery patients on their first postoperative day.
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Affiliation(s)
- Marion Good
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA.
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Drahota A, Ward D, Mackenzie H, Stores R, Higgins B, Gal D, Dean TP. Sensory environment on health-related outcomes of hospital patients. Cochrane Database Syst Rev 2012; 2012:CD005315. [PMID: 22419308 PMCID: PMC6464891 DOI: 10.1002/14651858.cd005315.pub2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hospital environments have recently received renewed interest, with considerable investments into building and renovating healthcare estates. Understanding the effectiveness of environmental interventions is important for resource utilisation and providing quality care. OBJECTIVES To assess the effect of hospital environments on adult patient health-related outcomes. SEARCH METHODS We searched: the Cochrane Central Register of Controlled Trials (last searched January 2006); MEDLINE (1902 to December 2006); EMBASE (January 1980 to February 2006); 14 other databases covering health, psychology, and the built environment; reference lists; and organisation websites. This review is currently being updated (MEDLINE last search October 2010), see Studies awaiting classification. SELECTION CRITERIA Randomised and non-randomised controlled trials, controlled before-and-after studies, and interrupted times series of environmental interventions in adult hospital patients reporting health-related outcomes. DATA COLLECTION AND ANALYSIS Two review authors independently undertook data extraction and 'Risk of bias' assessment. We contacted authors to obtain missing information. For continuous variables, we calculated a mean difference (MD) or standardized mean difference (SMD), and 95% confidence intervals (CI) for each study. For dichotomous variables, we calculated a risk ratio (RR) with 95% confidence intervals (95% CI). When appropriate, we used a random-effects model of meta-analysis. Heterogeneity was explored qualitatively and quantitatively based on risk of bias, case mix, hospital visit characteristics, and country of study. MAIN RESULTS Overall, 102 studies have been included in this review. Interventions explored were: 'positive distracters', to include aromas (two studies), audiovisual distractions (five studies), decoration (one study), and music (85 studies); interventions to reduce environmental stressors through physical changes, to include air quality (three studies), bedroom type (one study), flooring (two studies), furniture and furnishings (one study), lighting (one study), and temperature (one study); and multifaceted interventions (two studies). We did not find any studies meeting the inclusion criteria to evaluate: art, access to nature for example, through hospital gardens, atriums, flowers, and plants, ceilings, interventions to reduce hospital noise, patient controls, technologies, way-finding aids, or the provision of windows. Overall, it appears that music may improve patient-reported outcomes such as anxiety; however, the benefit for physiological outcomes, and medication consumption has less support. There are few studies to support or refute the implementation of physical changes, and except for air quality, the included studies demonstrated that physical changes to the hospital environment at least did no harm. AUTHORS' CONCLUSIONS Music may improve patient-reported outcomes in certain circumstances, so support for this relatively inexpensive intervention may be justified. For some environmental interventions, well designed research studies have yet to take place.
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Affiliation(s)
- Amy Drahota
- UK Cochrane Centre, National Institute for Health Research, Oxford, UK.
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The effect of perioperative psychological intervention on fatigue after laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 2012; 26:1730-6. [PMID: 22258294 DOI: 10.1007/s00464-011-2101-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 11/25/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Fatigue is one of the main complaints after surgery and may last longer than physical symptoms. It prevents return to normal function and activity. Relaxation interventions, performed prior to abdominal surgery, have been shown to reduce pain, wound erythema, and systemic cortisol levels. However, there is a lack of data on the impact of this intervention on patient well-being, functional recovery, activities of daily living, and fatigue after discharge from hospital. METHODS The study was a randomised single-blinded trial. Patients who were to undergo elective laparoscopic cholecystectomy for any indication between April 2008 and May 2010 were screened for inclusion. Those in the intervention group attended a standardised 45 min relaxation session with a health psychologist and were given relaxation exercise CDs to take home. The control group did not have the intervention. Patients were followed for 30 days. Fatigue was measured using the identity-consequence fatigue scale. RESULTS Seventy-five patients were randomised. Fifteen patients were excluded after randomization for various reasons; hence, 60 patients were followed up and analysed. Both groups had similar fatigue at baseline. There was improved fatigue and consequence of fatigue on postoperative day 30 in the intervention group. There was no difference in fatigue at any other time point postoperatively. CONCLUSION This was the first interventional study targeting fatigue after laparoscopic cholecystectomy by using a brief psychological relaxation intervention. It has shown a reduction of fatigue and impact of fatigue at 30 days postoperatively in the intervention group.
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Pinto PR, McIntyre T, Almeida A, Araújo-Soares V. The mediating role of pain catastrophizing in the relationship between presurgical anxiety and acute postsurgical pain after hysterectomy. Pain 2012; 153:218-226. [DOI: 10.1016/j.pain.2011.10.020] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Revised: 09/13/2011] [Accepted: 10/12/2011] [Indexed: 10/15/2022]
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Hayama Y, Inoue T. The effects of deep breathing on 'tension-anxiety' and fatigue in cancer patients undergoing adjuvant chemotherapy. Complement Ther Clin Pract 2011; 18:94-8. [PMID: 22500846 DOI: 10.1016/j.ctcp.2011.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Accepted: 10/18/2011] [Indexed: 11/25/2022]
Abstract
AIMS We investigated the effect of deep breathing intervention on 'tension-anxiety' and fatigue in Japanese women with gynaecological cancer undergoing adjuvant chemotherapy. SETTING A total of 23 patients were randomly allocated to intervention (n = 11) and control (n = 12) groups. INTERVENTION Deep breathing was practised in the intervention group, but not in the control group. Deep breathing comprised a 10-min breathing program comprising abdominal breathing, thoracic breathing and breathing with arms raised. Using the Profile of Mood States-Short Form (Japanese version) and the Cancer Fatigue Scale, the effects were assessed pre- and post-chemotherapy. RESULTS 'Tension-anxiety' and fatigue of the intervention group were relieved more than those of the control group. CONCLUSIONS The findings indicated that deep breathing intervention is likely to ameliorate the 'tension-anxiety' and fatigue in patients with gynaecological cancer undergoing adjuvant chemotherapy.
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Affiliation(s)
- Yuka Hayama
- Osaka University Graduate School of Medicine, Division of Health Sciences, 1-7 Yamadaoka Suita, Osaka 565-0871, Japan.
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Bernatzky G, Presch M, Anderson M, Panksepp J. Emotional foundations of music as a non-pharmacological pain management tool in modern medicine. Neurosci Biobehav Rev 2011; 35:1989-99. [DOI: 10.1016/j.neubiorev.2011.06.005] [Citation(s) in RCA: 135] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Revised: 06/09/2011] [Accepted: 06/09/2011] [Indexed: 01/01/2023]
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Abstract
The use of music as an intervention involves choices. What kind of music should be used? Who should choose the music? Thirty-one articles were reviewed. To maximize effects, the primary music selection should be based on research and then a variety of selections be presented to individuals for choice on the basis of personal preferences.
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Li XM, Yan H, Zhou KN, Dang SN, Wang DL, Zhang YP. Effects of music therapy on pain among female breast cancer patients after radical mastectomy: results from a randomized controlled trial. Breast Cancer Res Treat 2011; 128:411-9. [DOI: 10.1007/s10549-011-1533-z] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2010] [Accepted: 04/16/2011] [Indexed: 11/29/2022]
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The effect of relaxation techniques and back massage on pain and anxiety in Turkish total hip or knee arthroplasty patients. Pain Manag Nurs 2011; 14:143-54. [PMID: 23972865 DOI: 10.1016/j.pmn.2010.11.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2010] [Revised: 11/09/2010] [Accepted: 11/09/2010] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to examine the effects of relaxation techniques and back massage on postoperative pain, anxiety, and vital signs on postoperative days 1-3 in patients who had undergone total hip or knee arthroplasty (THA, TKA). Sixty patients having a THA or TKA were randomly assigned to either a experimental group or a control group. The McGill Pain Questionnaire Short Form (MPQ-SF) and State Anxiety Inventory (SAI) were used to measure pain and anxiety, respectively. Vital signs, including blood pressure (systolic and diastolic), pulse, and respiratory rate, were also obtained. Statistically significant differences in pain intensity (F = 14.50; p = .000), anxiety level (F = 19.13; p = .000), and vital signs (F = 169.61, 9.14, 14.23, 65.64; p = .000) measured over time were found between the experimental and the control group. Results of this research provide evidence to support the use of relaxation techniques and back massage at bed rest times of patients to decrease pain and anxiety. The interventions helped them to forget about their pain for a while and improved their anxiety state. After an evaluation of the conclusions, use of these interventions should be implemented by nurses into routine plans of care for patients.
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