Guided imagery: An effective pain management tool for total joint replacement?

The effect of guided imagery on postoperative pain and comfort of geriatric orthopaedic patients: a randomized controlled trial

BACKGROUND

The purpose of this study is to investigate the effects of guided imagery on postoperative pain and comfort in geriatric orthopedics patients.

METHODS

This study was carried out with a randomized-controlled true experimental design. The population of the study included geriatric patients receiving treatment at the orthopedics and traumatology inpatient clinic of a university hospital. Based on random selection, the sample consisted of total of 102 patients, including 40 patients in the experimental group and 40 in the control group. The data were collected using a Personal Information Form, the Visual Analog Scale, and the General Comfort Questionnaire.

RESULTS

After the guided imagery intervention, the pain levels of the experimental group significantly decreased compared to their baseline pain levels (t = 4.002, P = 0.00). Their perceived comfort was also significantly improved (t = -5.428, P = 0.00). Although the perceived comfort of the control group decreased, this decrease was not statistically significant (t = 0.698, P = 0.489).

CONCLUSION

It is recommended that guided imagery, which is an inexpensive and accessible method, be integrated into the nursing care process to reduce the pain and increase the comfort of geriatric orthopedics patients.

A systematic review of non-pharmacological interventions used for pain relief after orthopedic surgical procedures

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.