Effects of Reflexotherapy on Acute Postoperative Pain and Anxiety Among Patients With Digestive Cancer

Abstract

Even after receiving analgesia, patients with gastric and liver cancer still report moderate levels of postoperative pain. The purpose of the study was to investigate the efficacy of foot reflexotherapy as adjuvant therapy in relieving pain and anxiety in postoperative patients with gastric cancer and hepatocellular cancer. The study design was a randomized controlled trial. Data were collected from 4 surgical wards of a medical center in 2005 in Taipei, Taiwan. Sixty-one patients who had received surgery for gastric cancer or hepatocellular carcinoma were randomly allocated to an intervention (n = 30) or control (n = 31) group. Patients in the intervention group received the usual pain management plus 20 minutes of foot reflexotherapy during postoperative days 2, 3, and 4. Patients in the control group received usual pain management. Outcome measures included the short-form McGill Pain Questionnaire, visual analog scale for pain, summary of the pain medications consumed, and the Hospital Anxiety and Depression Scale. Results demonstrated that studied patients reported moderately high levels of pain and anxiety postoperatively while patients were managed with patient-controlled analgesia. Using generalized estimation equations and controlling for confounding variables, less pain (P < .05) and anxiety (P < .05) over time were reported by the intervention group compared with the control group. In addition, patients in the intervention group received significantly less opioid analgesics than the control group (P < .05). Findings from this study provide nurses with an additional treatment to offer postoperative digestive cancer patients.

Meta-Analysis of Massage Therapy on Cancer Pain

“…Massage was significantly effective against treatment-related cancer pain, especially cancer pain after surgery in 3 studies (SMD −1.86 [95% CI −2.78 to −0.94]; P < .0001; Supplemental Figure 1A). 11,16,19 There was also a significant effect of massage against cancer pain after chemotherapy in 3 studies (SMD −0.98 [95% CI −1.69 to −0.26]; P = 0.007; Supplemental Figure 1B). 14,15,19 There was also a significant effect of massage against cancer pain related to metastases in 3 studies (SMD −1.29 [95% CI −1.64 to −0.95]; P < .00001; Supplemental Figure 1C).…”

“…All types of cancer were included in 7 studies (SMD −1.11 [95% CI −1.50 to −0.71]; P < .00001; Supplemental Figure 2A). 9,11,[13][14][15]17 There was a significant effect of massage in breast cancer patients in 4 studies (SMD −1.11 [95% CI −1.50 to −0.72]; P < .00001; Supplemental Figure 2B). 10,12,13,16 There was also a significant effect of massage in digestive cancer in one study.…”

Investigating the Effect of Reflexology in Intensity of Pain and Anxiety Among Patients Suffering From Metastatic Cancer in Adults’ Hematology Ward

“…According to paired t-test results, there was a significant difference between the mean intensity of pain before and after the treatment. In the research by Tsay et al, reflexology also caused a significant reduction of pain in gastrointestinal cancer patients [28]. …”

“…This is a promising outcome in using non-pharmacological nursing care that mitigates pain and anxiety for patients, especially in cancer patients. Most studies around the world suggest a positive effect of reflexology on anxiety and pain in patients suffering from different problems including different types of cancer [19,26,27,28].…”

“…However, in the study by Tsay et al (2008) to determine the effectiveness of feet reflexotherapy in mitigating pain and anxiety in patients after stomach cancer surgery and blood cell cancer in Taiwan, the treatment group (massaging the digestive reflex points, i.e., upper and lower parts of the abdomen, liver, spleen, gallbladder, duodenum) had consumed significantly less painkiller. It seems that difference in massage points is the reason of different results between the two studies [28,31].…”