Nursing management of postoperative pain: use of relaxation techniques with female cholecystectomy patients

Levin, Rona F.; Malloy, Gail B.; Hyman, Ruth Bernstein

doi:10.1111/j.1365-2648.1987.tb01355.x

Cited by 38 publications

(52 citation statements)

References 32 publications

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“…The positive effects at rest are generally consistent with those of other studies of abdominal, orthopaedic, and GYN surgical patients who were not studied during ambulation (Levin et al, 1987;Locsin 1981;Mullooly et al, 1988;Nilsson et al, 2001;Osterbrink & Evers, 2000;Updyke, 1990;Wells, 1982). In this INT group, significance was found at fewer ambulation points (3/6) than those in the primary ABD a study (6/6) or the GYN intervention study (6/6).…”

Section: Discussionsupporting

confidence: 79%

“…Previous investigators have generally reported that these interventions were effective, both individually and in combination, after abdominal cardiac, and GYN surgeries (Good, 1995;Good et al, 1999 a ;Good, Stanton-Hicks et al, 2000 b ;Locsin, 1981;Mullooly, Levin, & Feldman, 1988;Nilsson, Rawal, Unestahl, Zetterberg, & Unosson, 2001; Updyke, 1990;Voss & Good, 2004). Relaxation techniques, such as deep breathing and jaw relaxation, have reduced postoperative pain after abdominal surgery (Flaherty & Fitzpatrick, 1978;Good et al, 1999 a ;Levin, Malloy, & Hyman, 1987;Roykulcharoen & Good, 2004;Wells, 1982) and orthopaedic surgery (Osterbrink & Evers, 2000). Music resulted in fairly large effect sizes in early clinical studies of children and adults with various types of pain: orthopaedic, obstetric, cardiac, gynecologic, dental, and terminal illness (Standley, 1986;Standley & Hanser, 1995).…”

mentioning

confidence: 99%

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Relaxation and music reduce pain following intestinal surgery

Good

Anderson

Ahn

et al. 2005

Research in Nursing & Health

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Three nonpharmacological nursing interventions, relaxation, chosen music, and their combination, were tested for pain relief following intestinal (INT) surgery in a randomized clinical trial. The 167 patients were randomly assigned to one of three intervention groups or control and were tested during ambulation and rest on postoperative days 1 and 2. Pain sensation and distress were measured with visual analog scales (VAS). Multivariate analysis of covariance showed significantly less post-test pain in the intervention groups than in the control group on both days after rest and at three of six ambulation post-tests (p ¼ .024-.001), resulting in 16-40% less pain. Mixed effects after ambulation were due to the large variation in pain and difficulty relaxing while returning to bed; but post hoc explorations showed effects for those with high and low pain. These interventions are recommended along with analgesics for greater postoperative relief without additional side effects.ß

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Section: Discussionsupporting

confidence: 79%

mentioning

confidence: 99%

Relaxation and music reduce pain following intestinal surgery

Good

Anderson

Ahn

et al. 2005

Research in Nursing & Health

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“…In addition, there was a graded effect: the combination treatment was significantly more effective than the individual interventions at day 1 rest. The post-hoc UV findings at rest were similar to (Levin et al, 1987) who used Benson's relaxation technique, (Locsin, 1981(Locsin, , 1988) who used preferred music to reduce pain behavior, and Mullooly et al (1988) (n = 11), who used easy listening music and found effects for both components of pain on day 2, and only for distress on day 1. Group sizes of Ͼ100 (Table 1) were probably the reason the findings were more positive than those in small preliminary studies.…”

Section: Restsupporting

confidence: 60%

“…In some studies relaxation or music reduced reports of sensory and affective pain (Flaherty and Fitzpatrick, 1978;Lawlis et al, 1985;Levin et al, 1987;Mullooly et al, 1988;Miller and Perry, 1990), while in others they reduced only affective pain (Wells, 1982;Horowitz et al, 1984;Mogan et al, 1985), had different results on different measures of pain (Good and Chin, 1998), or on different postoperative days (Good, 1995;Good and Chin, 1998). In other studies relaxation or music had no effect on pain but reportedly, provided a relaxing and pleasant experience (Heitz et al, 1992;Zimmerman et al, 1996;Heiser et al, 1997).…”

Section: Introductionmentioning

confidence: 99%

Relief of postoperative pain with jaw relaxation, music and their combination

Good

Stanton‐Hicks

Grass

et al. 1999

Pain

204

209

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The aim of this randomized controlled trial was to determine the effect of jaw relaxation, music and the combination of relaxation and music on postoperative pain after major abdominal surgery during ambulation and rest on postoperative days 1 and 2. Opioid medication provided for pain, following abdominal surgery, does not always give sufficient relief and can cause undesired side effects. Thus, additional interventions such as music and relaxation may provide more complete relief. Previous studies have found mixed results due to small sample sizes and other methodological problems. In a rigorous experimental design, 500 subjects aged 18-70 in five Midwestern hospitals were randomly assigned by minimization to a relaxation, music, relaxation plus music, or control group. Interventions were taught preoperatively and tested postoperatively. The same amount of time was spent with subjects in the control group. Pain was measured with the visual analogue sensation and distress of pain scales. Demographic and surgical variables, and milligrams of parenteral or oral opioids in effect at the time of testing were not significantly different between the groups, nor did they correlate with pain scores. Controlling for pretest sensation and distress, orthogonal a priori contrasts and multivariate analysis of covariance indicated that the three treatment groups had significantly less pain than the controls, (P = 0.028-0.000) which was confirmed by the univariate analysis of covariance (P = 0.018-0.000). Post hoc multivariate analysis revealed that the combination group had significantly less sensation and distress of pain than the control group on all post-tests (P = 0.035-0.000), and the relaxation and music groups had significantly less on all tests (P = 0.022-0.000) except after ambulation. At post ambulation those using relaxation did not have significantly less pain than the controls on both days and those using music did not on day 1, although there were some univariate effects. A corresponding significant decrease in mastery of the interventions from pre to post ambulation suggests the need for reminders to focus on the intervention during this increased activity. Physicians and nurses preparing patients for surgery and caring for them afterward, should encourage patients to use relaxation and music as adjuvants to medication for postoperative pain.

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“…Aiken & Henrichs, 1971;Flaherty & Fitzpatrick, 1978 ;Johnson, Morrissey & Leventhal, 1973 ;Johnson, Rice, Fuller & Endress, 1978a;Levin, Malloy & Hyman, 1987;Sime, 1976). Information provision has been the most frequently studied intervention (Anderson, 1987;Johnson, Fuller, Endress & Rice, 1978b;Johnson & Leventhal, 1974;Johnson e t al., 1973;Langer, Janis & Wolfer, 1975;Miller & Mangen, 1983;Vernon & Bigelow, 1974;Wallace, 1984;Wilson, 1981).…”

mentioning

confidence: 97%

Anxiety, relaxation and anaesthesia for day‐case surgery

Markland

Hardy

1993

British J Clinic Psychol

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It is recognized that pre-operative anxiety can have adverse effects on the course and outcome of surgery and there is a considerable amount of research into the influences of interventions for pre-operative anxiety on a number of post-operative variables. However, little attention has been paid to the potential influences of treatments on intra-operative variables, most notably on the facilitation of anaesthesia. The present study examined the impact of a brief relaxation procedure on anaesthesia in comparison to attention-control and no-treatment control procedures. A sample of 21 patients about to undergo anaesthesia for day-case surgery were randomly assigned to one of the three conditions. It was found that the relaxation treatment significantly reduced pre-operative anxiety as measured by the state scale of the State-Trait Anxiety Inventory (Spielberger, 1983). This reduction was reflected in physiological indicators of anxiety. Both the relaxation group and the attention-control group required significantly less time to induce anaesthesia and less of the anaesthetic agent used to maintain anaesthesia. The relaxation group also scored significantly lower than the no-treatment control group on an anaesthetist's rating of difficulty of maintenance of anaesthesia. Whilst the relaxation treatment appeared to have no advantages over the attention-control procedure in terms of anaesthetic requirements, the latter treatment did not reduce anxiety and showed no benefit over the no-treatment control condition in terms of an anaesthetist's rating of difficulty of maintenance of anaesthesia. In addition, following recovery the relaxation subjects reported more favourable perceptions of their treatment than the attention-control subjects.

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Nursing management of postoperative pain: use of relaxation techniques with female cholecystectomy patients

Cited by 38 publications

References 32 publications

Relaxation and music reduce pain following intestinal surgery

Relaxation and music reduce pain following intestinal surgery

Relief of postoperative pain with jaw relaxation, music and their combination

Anxiety, relaxation and anaesthesia for day‐case surgery

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