Benson Relaxation Technique in Reducing Pain Intensity in Women After Cesarean Section

The Effect of Benson Relaxation Technique on Stress, Anxiety, and Depression in Pregnant Women

Relaxation programs can be effective in establishing psychological tranquility for maternal and fetal health. This study was conducted to evaluate the effect of this low-cost, effective, easy method on the stress, anxiety, and depression in pregnant women. This randomized clinical trial study was conducted from July 2015 to July 2016. Seventy pregnant women in the third trimester of pregnancy were included in this study. Participants were randomly assigned to 2 groups of 35 subjects using a random number table. Participants in group 1 received relaxation training and group 2 received routine care. A demographic questionnaire and Depression, Anxiety, and Stress Scale (DASS-21) were completed before and 1 and 2 months after the intervention. The SPSS software version 18 was used for data analysis. There were significant differences in the mean difference of the total DASS score (14; 95% confidence interval [CI]: 4 to 32) as well as the scores of stress (4; 95% CI : 1 to 10), anxiety (6; 95% CI: 2 to 10), and depression (6; 95% CI: 2 to 12) 2 months after the intervention between the 2 groups. The Benson relaxation technique decreased DASS-21 scores in the intervention group.

Functional recovery after cesarean delivery: a prospective cohort study in rural Rwanda

INTRODUCTION

Women who deliver via cesarean section (c-section) experience short- and long-term disability that may affect their physical health and their ability to function normally. While clinical complications are assessed, postpartum functional outcomes are not well understood from a patient's perspective or well-characterized by previous studies. In Rwanda, 11% of rural women deliver via c-section. This study explores the functional recovery of rural Rwandan women after c-section and assesses factors that predict poor functionality at postoperative day (POD) 30.

METHODS

Data were collected prospectively on POD 3, 11, and 30 from women delivering at Kirehe District Hospital between October 2019 and March 2020. Functionality was measured by self-reported overall health, energy level, mobility, self-care ability, and ability to perform usual activities; and each domain was rated on a 4-point likert scale, lower scores reflecting higher level of difficulties. Using the four functionality domains, we computed composite mean scores with a maximum score of 4.0 and we defined poor functionality as composite score of ≤ 2.0. We assessed functionality with descriptive statistics and logistic regression.

RESULTS

Of 617 patients, 54.0%, 25.9%, and 26.8% reported poor functional status at POD3, POD11, and POD30, respectively. At POD30, the most self-reported poor functionality dimensions were poor or very poor overall health (48.1%), and inability to perform usual activities (15.6%). In the adjusted model, women whose surgery lasted 30-45 min had higher odds of poor functionality (aOR = 1.85, p = 0.01), as did women who experienced intraoperative complications (aOR = 4.12, 95% CI (1.09, 25.57), p = 0.037). High income patients had incrementally lower significant odds of poor physical functionality (aOR = 0.62 for every US$1 increase in monthly income, 95% CI (0.40, 0.96) p = 0.04).

CONCLUSION

We found a high proportion of poor physical functionality 30 days post-c-section in this Rwandan cohort. Surgery lasting > 30 min and intra-operative complications were associated with poor functionality, whereas a reported higher income status was associated with lower odds of poor functionality. Functional status assessments, monitoring and support should be included in post-partum care for women who delivered via c-section. Effective risk mitigating intervention should be implemented to recover functionality after c-section, particularly among low-income women and those undergoing longer surgical procedures or those with intraoperative complications.

The effect of Benson relaxation technique on cancer patients: a systematic review

PURPOSE

Although many studies have investigated the effect of this method on cancer patients, no review of the available literature has been done. So, a literature review is conducted to evaluate all published literature on the Benson relaxation technique in cancer patients.

METHODS

A systematic literature search was conducted. A systematic search of online electronic databases including PubMed/MEDLINE, Scopus Web of Science, PsycINFO, and EMBASE was performed using keywords extracted from Medical Subject Headings such as "Benson Relaxation Technique," "Cancer Patients," "Malignancy," and "Neoplasia" from the beginning to April 27, 2023. A total of 810 publications were assessed for relevance by title and abstract. The remaining 31 articles were examined using inclusion criteria for all Persian and English-language publications that evaluate the effectiveness of the Benson relaxation technique on cancer patients. We did not have gray literature in our review. The methodological quality of the included studies was appraised using specific checklists.

RESULTS

Finally, nine studies were included in this systematic review. Studies on breast cancer patients showed improvement in fatigue, nausea, vomiting, pain, shortness of breath, insomnia, anorexia, constipation, diarrhea, treatment side effects, breast symptoms, arm symptoms, worry about hair loss, and scores of hope. Two studies were conducted among cervical cancer patients that showed a decrease in anxiety scores and an improvement in the quality of sleep. Another study on gastric cancer patients showed decreased Chemotherapy-Induced Nausea, Vomiting, and Retching scores.

CONCLUSION

Overall, this systematic review showed that the Benson relaxation method could improve sleep quality, appetite, anxiety, and quality of life. Therefore, using the Benson relaxation technique is suggested to improve health-related outcomes in cancer patients.

Comparison of the effects of Benson relaxation technique and nature sounds on pain, anxiety, and body image in burn-injured patients admitted to the burn ICU: A single-blind randomized clinical trial

BACKGROUND

Burn patients feel a lot of physiological and mental stress during treatment and rehabilitation which often cause anxiety and body image dissatisfaction. This study aimed to compare the effects of the Benson relaxation technique and nature sounds on pain anxiety and body image in burn-injured patients admitted to a burn intensive care unit (BICU).

METHODS

This single-blind randomized clinical trial studied 60 burn patients allocated into three groups (Benson relaxation, nature sounds, and control) from September 2021 to February 2022. The patients received the intervention for seven consecutive days in person. Burn Specific Pain Anxiety Scale (BSPAS), was completed on the 1st, 4th, and 7th days. The intervention continued for four weeks measuring body image using the Satisfaction with Appearance Scale (SWAP) at the end of the 1st, 3rd, and 5th weeks. Finally, the data were statistically analyzed using the Shapiro-Wilk test, chi-square test, Fisher's exact test, Bonferroni post hoc test, repeated measures ANOVA, Kruskal Wallis test, and Generalize Estimating Equations (GEE).

RESULTS

The mean pain anxiety and dissatisfaction with the appearance were high in the three groups in the pretest. On the 7th day after the intervention, the ANOVA showed that the mean pain anxiety decreased significantly in Benson's relaxation and nature sounds groups in three stages (before intervention (S1), after intervention (S2) and immediately after dressing change (S3) (P < 0.001). Correspondingly, the Kruskal Wallis test revealed that the body image dissatisfaction decreased significantly in the three groups at the end of the 3rd and 5th weeks (P < 0.001). The mean scores of pain anxiety showed that the nature sounds group proved more effective than the Benson relaxation technique. Also, the means scores of body image satisfaction showed that the Benson relaxation technique proved more effective than nature sounds.

CONCLUSION

The study findings suggested that the Benson relaxation technique and nature sounds effectively reduces pain, anxiety, and improves body image satisfaction in patients with burn injuries.

The Role of Benson's and Mitchell's Relaxation Techniques in the Management of Premenstrual Syndrome: An In-Depth Review

Premenstrual syndrome (PMS) is a menstrual disorder characterized by physical, behavioral, and emotional symptoms typically occurring during the luteal phase. These symptoms are usually mild and somatic and often subside during or just before the start of menstruation. Medical professionals employ pharmacological and non-pharmacological treatments as the primary approach to managing PMS. One effective non-pharmacological method is Laura Mitchell's physiological relaxation treatment, which has been shown to enhance immunological function, reduce depression, and improve the overall quality of life. Another beneficial technique is Benson's relaxation technique, established by Herbert Benson in 1970, providing a simple yet powerful stress-release strategy. For this study, research papers were searched using various reputable databases such as PubMed, Scopus, Web of Science, and Google Scholar websites, with data collected up to the end of 2021. The publication dates of the review articles were not restricted, allowing for a comprehensive overview. However, it is important to note that only a limited number of accessible studies have been found, underscoring the need for further research. Future investigations should focus on high-quality evidence with reliable outcome measures to draw more conclusive results about which relaxation technique offers better relief for PMS.

Effect of Foot Reflexology and Benson Relaxation on Pain, Breastfeeding and Weight of Neonates of Women Undergoing a Cesarean Section

BACKGROUND

Given the negative effect of postoperative pharmacological pain control on breastfeeding, the present study aimed to compare the effects of reflexology and Benson relaxation methods on pain, breastfeeding, and infant weight gain in women undergoing a cesarean section (C/S).

METHODS

This randomized clinical trial was conducted on 135 women undergoing a C/S in the Gynecology Ward of Bushehr Persian Gulf Martyrs Hospital in Bushehr, Iran, in 2020. The participants were selected using convenience sampling, and randomly divided into three groups of foot reflexology, Benson relaxation, and control. The interventions were performed two hours post-operation and six hours after the first intervention. The pain score was measured and recorded immediately, and 30 and 60 minutes after each intervention. Breastfeeding frequency and duration were also assessed in the first 18 hours of birth. The infants' weight was assessed at birth and 10 days later. Data analysis was performed using inferential statistics, chi-square or Fisher's exact test, Kruskal-Wallis test, Mann-Whitney U or one-way ANOVA, Wilcoxon test and logistic regression analysis.

RESULTS

There was a larger decrease in the pain score of the reflexology and Benson relaxation (P<0.01) groups after the first and second interventions, compared to the control group. The breastfeeding frequency was higher in the two intervention groups, compared to the control group (P<0.001). Furthermore, the rate of return to the birth weight in ten days of birth was higher in the reflexology (P<0.01) and Benson groups (P<0.05) than the control group.

CONCLUSION

Both the reflexology and the Benson relaxation methods effectively decreased pain and increased breastfeeding frequency and the infant's weight gain.

Effects of Benson Relaxation Technique and Music Therapy on the Anxiety of Primiparous Women Prior to Cesarean Section: A Randomized Controlled Trial

Background and Aims

Primiparous women experience high levels of anxiety before cesarean section. Therefore, this research aimed to investigate the effects of the Benson Relaxation Technique (BRT) and Music Therapy (MT) on the anxiety of primiparous women prior to cesarean section.

Methods

A randomized controlled trial was carried out on 105 women scheduled for cesarean section. They were randomly assigned into three groups: BRT, MT, and control (n = 35 per group). The women in the BRT and MT groups performed exercises and listened to music, respectively, for 20 minutes prior to cesarean section. The State Anxiety Inventory was used to measure the women's anxiety in the groups before and after the intervention.

Results

Within-group comparisons showed that the women in the BRT (t = 5.61, p < 0.001, effect size (Cohen's d) = 0.94) and MT (t = 3.83, p = 0.001, d = 0.64) groups had significantly lower anxiety after the interventions compared to before the interventions. Also, between-group comparisons revealed that anxiety after the intervention was significantly lower in the BRT and MT groups compared to the control group (p = 0.007).

Conclusions

Although both of the BRT and MT helped with the reduction of anxiety among primiparous women before cesarean section, the BRT was shown more effective. These nonpharmacologic methods are safe and cost-effective and can improve well-being among women undergoing this invasive procedure. They can be used along with pharmacologic methods for reducing overreliance on medications.

Evaluation of breastfeeding success and self-efficacy in mothers giving birth via vaginal delivery or cesarean section: a cross-sectional study

This cross-sectional observational study was conducted to compare breastfeeding success and breastfeeding self-efficacy levels of mothers who gave birth via vaginal delivery (spontaneous or via epidural analgesia) or cesarean section (under general or spinal anesthesia). The study was conducted between September 2019 and February 2020 in the obstetric clinic. Data were collected using a Data Collection Form, the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), and the LATCH Breastfeeding Evaluation Tool. Throughout the study, we followed the STROBE Checklist. Mothers who gave birth via spontaneous vaginal delivery had a statistically higher mean Breastfeeding Self-Efficacy score (54.92 ± 7.72; p < .001) than those who gave birth under spinal anesthesia (43.21 ± 10.04; p < .001) and then those who gave birth via cesarean section under general anesthesia (37.39 ± 10.64; p < .001). The difference between the delivery modes in terms of breastfeeding self-efficacy and breastfeeding success scores was statistically significant (respectively, KW = 40.168, p < .001 and KW = 52.420, p < .001). In order to increase the breastfeeding success of mothers who give birth via cesarean section under general anesthesia or spinal anesthesia, lactation nurses need to strengthen the perception of breastfeeding self-efficacy and provide more breastfeeding support to them compared to mothers who give birth via SVD.

Effectiveness of mental simulations on the early mobilization of patients after cesarean section: a randomized controlled trial

We aimed to investigate whether psychological intervention (single mental simulation) among women after cesarean surgery (CC) can affect their willingness to verticalize, actual verticalization, and the duration of the first mobilization. In this prospective randomised, controlled study, 150 women after CC were divided into 3 groups: experimental group with process-simulation with elements of relaxation, experimental group with outcome-simulation with elements of relaxation and control group with elements of relaxation only. After a 5-h stay in the post-operative room, women listened to a recording with a stimulation. Pain and anxiety of verticalization were measured before and after listening to the recording and after verticalization. Almost 12% more patients verticalized in the process-simulation group than in the control group. Percentages of mobilized patients were: 39.4% the process-simulation group; 32.8% in the outcome-simulation group; 27.7% controls (p = 0.073). Mobilization was 5 min longer in the process-simulation group then in control (p < 0.01). Anxiety after the simulation was a significant covariate of the willingness to verticalize, actual verticalization and time spent in mobilization. We conclude that a single mental simulation can effectively motivate patients for their first verticalization after CC. Perceived anxiety before verticalization may affect the effectiveness of interventions, so we recommend to check it at the postoperative care.

ClinicalTrials.gov Identifier: NCT04829266.

The Effect of Benson Relaxation Technique on Depression, Anxiety, and Stress of Jordanian Patients Diagnosed with Multiple Sclerosis: A Cross-Sectional Study

Depression, anxiety, and stress (DAS) are common symptoms of multiple sclerosis (MS) patients and are highly correlated with poor quality of life. Managing DAS among such patients can improve their quality of life (QoL), empowering them with improved autonomy, self-care, independency, and ability to perform daily activities. This study is aimed at examining the effectiveness of the Benson Relaxation Technique (BRT) on reducing DAS among patients diagnosed with MS in Jordan. This quasiexperimental study of 105 Jordanian patients diagnosed with multiple sclerosis tested an intervention group (60 patients) who received BRT and a control group (45 patients) who received normal treatment. Data were collected from January 2021 to April 2021, using the Arabic version of the Depression Anxiety Stress Scale (DASS21). The intervention group was instructed to perform the BRT two times a day for 10 minutes at home for eight weeks at two specific times, with 7-8-hour intervals between each episode. STROBE guidelines were followed in reporting the review. At the baseline comparison, there was no statistical difference between the interventional and control groups with regard to DAS. The levels of DAS between the two groups after three months of the last sessions of the intervention (postintervention) were compared. The results showed that the intervention group had significantly lower levels of DAS compared to the control group. The levels of the DAS were significantly lower for the intervention group postintervention. Adding relaxation techniques to the therapeutic routine is a cost-effective complementary treatment to decrease DAS among MS patients and improve their QoL. Relevance to Practice. This study provides a baseline of data that could facilitate further investigations in the future to improve the quality of services delivered to such patients and thus their QoL and satisfaction.

Complementary and alternative therapies for post-caesarean pain

BACKGROUND

Pain after caesarean sections (CS) can affect the well-being of the mother and her ability with her newborn. Conventional pain-relieving strategies are often underused because of concerns about the adverse maternal and neonatal effects. Complementary alternative therapies (CAM) may offer an alternative for post-CS pain.

OBJECTIVES

To assess the effects of CAM for post-caesarean pain.

SEARCH METHODS

We searched Cochrane Pregnancy and Childbirth's Trials Register, LILACS, PEDro, CAMbase, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP) (6 September 2019), and checked the reference lists of retrieved articles.

SELECTION CRITERIA

Randomised controlled trials (RCTs), including quasi-RCTs and cluster-RCTs, comparing CAM, alone or associated with other forms of pain relief, versus other treatments or placebo or no treatment, for the treatment of post-CS pain.

DATA COLLECTION AND ANALYSIS

Two review authors independently performed study selection, extracted data, assessed risk of bias and assessed the certainty of evidence using GRADE.

MAIN RESULTS

We included 37 studies (3076 women) which investigated eight different CAM therapies for post-CS pain relief. There is substantial heterogeneity among the trials. We downgraded the certainty of evidence due to small numbers of women participating in the trials and to risk of bias related to lack of blinding and inadequate reporting of randomisation processes. None of the trials reported pain at six weeks after discharge. Primary outcomes were pain and adverse effects, reported per intervention below. Secondary outcomes included vital signs, rescue analgesic requirement at six weeks after discharge; all of which were poorly reported, not reported, or we are uncertain as to the effect Acupuncture or acupressure We are very uncertain if acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus placebo plus analgesia) has any effect on pain because the quality of evidence is very low. Acupuncture or acupressure plus analgesia (versus analgesia) may reduce pain at 12 hours (standardised mean difference (SMD) -0.28, 95% confidence interval (CI) -0.64 to 0.07; 130 women; 2 studies; low-certainty evidence) and 24 hours (SMD -0.63, 95% CI -0.99 to -0.26; 2 studies; 130 women; low-certainty evidence). It is uncertain whether acupuncture or acupressure (versus no treatment) or acupuncture or acupressure plus analgesia (versus analgesia) has any effect on the risk of adverse effects because the quality of evidence is very low. Aromatherapy Aromatherapy plus analgesia may reduce pain when compared with placebo plus analgesia at 12 hours (mean difference (MD) -2.63 visual analogue scale (VAS), 95% CI -3.48 to -1.77; 3 studies; 360 women; low-certainty evidence) and 24 hours (MD -3.38 VAS, 95% CI -3.85 to -2.91; 1 study; 200 women; low-certainty evidence). We are uncertain if aromatherapy plus analgesia has any effect on adverse effects (anxiety) compared with placebo plus analgesia. Electromagnetic therapy Electromagnetic therapy may reduce pain compared with placebo plus analgesia at 12 hours (MD -8.00, 95% CI -11.65 to -4.35; 1 study; 72 women; low-certainty evidence) and 24 hours (MD -13.00 VAS, 95% CI -17.13 to -8.87; 1 study; 72 women; low-certainty evidence). Massage We identified six studies (651 women), five of which were quasi-RCTs, comparing massage (foot and hand) plus analgesia versus analgesia. All the evidence relating to pain, adverse effects (anxiety), vital signs and rescue analgesic requirement was very low-certainty. Music Music plus analgesia may reduce pain when compared with placebo plus analgesia at one hour (SMD -0.84, 95% CI -1.23 to -0.46; participants = 115; studies = 2; I2 = 0%; low-certainty evidence), 24 hours (MD -1.79, 95% CI -2.67 to -0.91; 1 study; 38 women; low-certainty evidence), and also when compared with analgesia at one hour (MD -2.11, 95% CI -3.11 to -1.10; 1 study; 38 women; low-certainty evidence) and at 24 hours (MD -2.69, 95% CI -3.67 to -1.70; 1 study; 38 women; low-certainty evidence). It is uncertain whether music plus analgesia has any effect on adverse effects (anxiety), when compared with placebo plus analgesia because the quality of evidence is very low. Reiki We are uncertain if Reiki plus analgesia compared with analgesia alone has any effect on pain, adverse effects, vital signs or rescue analgesic requirement because the quality of evidence is very low (one study, 90 women). Relaxation Relaxation may reduce pain compared with standard care at 24 hours (MD -0.53 VAS, 95% CI -1.05 to -0.01; 1 study; 60 women; low-certainty evidence). Transcutaneous electrical nerve stimulation TENS (versus no treatment) may reduce pain at one hour (MD -2.26, 95% CI -3.35 to -1.17; 1 study; 40 women; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce pain compared with placebo plus analgesia at one hour (SMD -1.10 VAS, 95% CI -1.37 to -0.82; 3 studies; 238 women; low-certainty evidence) and at 24 hours (MD -0.70 VAS, 95% CI -0.87 to -0.53; 108 women; 1 study; low-certainty evidence). TENS plus analgesia (versus placebo plus analgesia) may reduce heart rate (MD -7.00 bpm, 95% CI -7.63 to -6.37; 108 women; 1 study; low-certainty evidence) and respiratory rate (MD -1.10 brpm, 95% CI -1.26 to -0.94; 108 women; 1 study; low-certainty evidence). We are uncertain if TENS plus analgesia (versus analgesia) has any effect on pain at six hours or 24 hours, or vital signs because the quality of evidence is very low (two studies, 92 women).

AUTHORS' CONCLUSIONS

Some CAM therapies may help reduce post-CS pain for up to 24 hours. The evidence on adverse events is too uncertain to make any judgements on safety and we have no evidence about the longer-term effects on pain. Since pain control is the most relevant outcome for post-CS women and their clinicians, it is important that future studies of CAM for post-CS pain measure pain as a primary outcome, preferably as the proportion of participants with at least moderate (30%) or substantial (50%) pain relief. Measuring pain as a dichotomous variable would improve the certainty of evidence and it is easy to understand for non-specialists. Future trials also need to be large enough to detect effects on clinical outcomes; measure other important outcomes as listed lin this review, and use validated scales.

Effects of Relaxation Techniques on Acute Postlaminectomy Pain: A Three-Arm Randomized Controlled Clinical Trial

PURPOSE

This study compared the effects of Benson relaxation with progressive muscle relaxation on pain severity after laminectomy.

DESIGN

Three-arm randomized, nonblinded, and parallel group trial.

METHODS

The study was conducted with 93 patients who underwent lumbar laminectomy. Patients were randomly assigned to three groups of Benson relaxation + routine care (n = 31), progressive muscle relaxation + routine care (n = 31), and routine care (n = 31). The two relaxation methods were performed at 2 (time 1), 12 (time 2), and 24 (time 3) hours after patients' regaining full consciousness in postoperative wards. Pain severity was assessed using the visual analog scale once before laminectomy, before and also 20 minutes after each relaxation session. In the control group, pain severity was measured at the same times as in the two relaxation groups.

FINDINGS

Both Benson relaxation and progressive muscle relaxation resulted in a significant reduction in pain severity in comparison with the control group at all three measurement times (except at time 1 in the progressive muscle relaxation group). However, no significant differences were found between Benson relaxation and progressive muscle relaxation in any of the three times.

CONCLUSIONS

The results suggest that both Benson and progressive muscle relaxation techniques can decrease acute postlaminectomy pain in the immediate postoperative period in adult patients.

The potential beneficial effects of education and familiarity with cesarean section procedure and the operating room environment on promotion of anxiety and pain intensity: A randomized controlled clinical trial

BACKGROUND

Anxiety before and pain intensity after cesarean section is among the factors that should be taken into consideration among the candidates for cesarean section. The present study aimed to investigate the effect of familiarity with cesarean section and the operating room environment on anxiety and pain intensity among the mothers undergoing cesarean section.

METHODS

This clinical trial was conducted on 80 women referred to the hospitals affiliated to Shiraz University of Medical Sciences for cesarean section in 2018. The participants were randomly divided into a control (n = 40) and an intervention group (n = 40). The intervention group took part in four educational sessions, while the control group received the hospital's routine care. The Beck Anxiety Inventory was completed by the two groups before and after the intervention. The McGill Pain Questionnaire was also filled out by the two groups in the ward after the cesarean section. After all, the data were entered into the SPSS software, version 21, and were analyzed using independent t-test and ANCOVA.

RESULTS

The results showed no significant difference between the two groups regarding the mean score of anxiety prior to the intervention. After the intervention, the mean score of anxiety was 7.98 ± 3.77 in the intervention group and 19.70 ± 6.45 in the control group, and the difference was statistically significant (P < 0.0001). Indeed, the mean intensity of pain was 43.98 ± 7.63 in the intervention group and 57.75 ± 10.69 in the control group after the intervention, and the difference was statistically significant (P < 0.017).

CONCLUSION

The patients' familiarity with cesarean section and the operating room environment caused a decline in the anxiety level prior to cesarean section as well as a decrease in the score of pain after the operation. Hence, midwives and nurses have to play effective roles in decreasing pregnant women's anxiety and pain through identification of strategies for empowering them and managing their worries.

Evaluation of Percutaneous Electrical Nerve Stimulation of the Auricle for Relief of Postoperative Pain Following Cesarean Section

Objective: Percutaneous electrical nerve stimulation is a nonpharmacologic modality of analgesia. This study was conducted to evaluate such a technology (ANSiStim™, DyAnsys Inc., San Mateo, CA) prospectively, in conjunction with standard analgesia per patient demand, for managing postoperative pain following lower-segment cesarean section. Materials and Methods: One hundred parturients were randomized into 2 equal groups (controls and study cases). The latter cohort consisted of parturients for whom nerve stimulation was exerted on the pinna. Pain scores were compared across subjects at corresponding time points with 17 intervals in 48 hours, and, in totality, using estimated area under the curves of numerical scores. Conditional inference analysis was also performed. Results: Ninety-six parturients were finally included. The device was well-tolerated by a majority of parturients. Pain scores were significantly lower in the study group, both at corresponding time intervals and in totality. (H - 15)*(0.74 - H)*(H² - 17H + 110)/440, where H was the corresponding hour, fit the pain scores in the control group. Controls could be detected at the 11 hour with greater pain scores (≥ 4), whereas smaller scores (≤ 2) at the 42nd hour mostly revealed that electrical stimulation was performed (p < 0.001). Requirements for supplementary analgesics were lower for subjects who were given the electroanalgesia. Conclusions: Neurostimulation via the ANSiStim™ is a safe and reasonably effective ambulatory analgesic adjuvant following abdominal delivery. There are no serious adverse effects.

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

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.

Effect of the combination of Benson's relaxation technique and brief psychoeducational intervention on multidimensional pain and negative psychological symptoms of pregnant women: A randomized controlled trial

BACKGROUND

Pregnancy is associated with negative psychological symptoms (NPS) and multidimensional pain. Therefore, the present study was conducted to determine the effect of the combination of Benson's relaxation technique (BRT) and brief psychoeducational intervention (BPI) on multidimensional pain and NPS of pregnant women.

MATERIALS AND METHODS

The present randomized clinical trial was conducted on pregnant women referred to Imam Reza and Motazedi Hospitals in Kermanshah, Iran. In this regard, 60 pregnant women were randomly allocated to intervention (n = 30) and control (n = 30) groups. The groups attended BRT and BPI educational sessions for 4 weeks, but the control group received no intervention. Subsequently, both groups completed Depression Anxiety Stress Scale-21 and multidimensional pain inventory.

RESULTS

The mean NPS (stress, anxiety, and depression) was significantly decreased in the intervention group (P < 0.001), while no statistically significant differences were observed in the control group (P > 0.05). The independent t-test revealed a significant difference between the mean scores of intervention and control groups (P < 0.001). The mean multidimensional pain was significantly decreased in mothers after the completion of educational sessions (P < 0.001), and the independent t-test results indicated a significant difference between the scores of the intervention and control groups (P < 0.001).

CONCLUSION

The results of this study suggested that the combination of BRT and BPI can lead to a reduction in the NPS and multidimensional pain in the pregnant women. This intervention is recommended to be considered as part of a healthcare program in pregnant mothers.

The effect of Benson relaxation method on anxiety in the emergency care

OBJECTIVE

To analyze clinical and sociodemographic properties of the patients as measured by the "Hospital Anxiety and Depression Scale-HADS" including the subscale regarding anxiety (HAD-A) in emergency department (ED) and to detect the effect of a session of Benson relaxation method (BRM) on high anxiety level.

METHODS

Adult patients presented to the state hospital ED in seven days were recruited in this prospective study. Patients with high (≥8) scores were randomized to the treatment or control groups. They were asked to pursue BRM to alleviate anxiety.

RESULTS

Six hundred thirty-four patients were recruited (mean age 44.1 and 52% were female). Patients with acute exacerbation or with psychiatric illness, with a systemic disease and higher acuity level had higher HAD-A scores (P < .05). BRM group had a mean score change higher than controls (7.2 ± 2.9 vs 3.4 ± 2.6, t test, P = .026).

CONCLUSIONS

Patients who underwent BRM had larger decreases in HAD-A scores than others.