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New research has found that relaxation and music,
separately or together, significantly reduce patients' pain
following major abdominal surgery. The study, published in the May
issue of Pain, found that these methods in combination with
pain medication reduce pain more than pain medication alone. Led
by Marion Good, PhD, RN, of Frances Payne Bolton School of
Nursing, Case Western Reserve University, Cleveland, Ohio, the
study is supported by the National Institute of Nursing Research (NINR),
at the National Institutes of Health.
"There are millions of people who undergo surgery and
experience postoperative pain each year," said Dr. Patricia
A. Grady, director of the NINR. "Better pain management can
reduce hospital stays and speed recovery, ultimately improving
patients' quality of life."
Dr. Good and her research team studied three groups of patients
undergoing abdominal surgery. In addition to the usual pain
medication, one group used a jaw relaxation technique, another
group listened to music, and a third group received a combination
of relaxation and music. Findings revealed that, after surgery,
the three treatment groups had significantly less pain than the
control group, which received only pain medication.
"Both medication and self-care methods which involve
patient participation are needed for relief," said Dr. Good.
"These relaxation and music self-care methods provide more
complete relief without the undesired side effects of some pain
medications."
The findings have important implications for the 23 million
people who undergo surgery and experience postoperative pain
annually in the United States. Pain can hamper recovery by
heightening the body's response to the stress of surgery and
increasing tissue breakdown, coagulation and fluid retention. Pain
also interferes with appetite and sleep and can lead to
complications that prolong hospitalization.
Dr. Good and her research staff worked with 500 patients aged
18-70, who were undergoing gynecological, gastrointestinal,
exploratory or urinary surgery. Prior to surgery, those in the
music, relaxation or combination groups practiced the techniques.
The relaxation technique consisted of letting the lower jaw drop
slightly, softening the lips, resting the tongue in the bottom of
the mouth, and breathing slowly and rhythmically with a
three-rhythm pattern of inhale, exhale and rest. Patients in the
music group chose one of five kinds of soothing music--harp,
piano, synthesizer, orchestral or slow jazz.
On the first and second days after surgery, all patients
received morphine or Demerol for pain relief by pressing a button
connected to their intravenous patient controlled analgesia pumps.
The groups receiving the additional intervention used earphones to
listen to music and relaxation tapes during walking and rest,
while the control group did not. The research team measured the
patients' pain before and after 15 minutes of bed rest and four
times during walking to see if the sensation and distress of pain
changed. Dr. Good found that on the first and second days
postsurgery the three treatment groups had significantly less pain
than the control group during both walking and rest.
"Patients can take more control of their postoperative
pain using these self-care methods," says Dr. Good.
"Nurses and physicians preparing patients for surgery and
caring for them afterwards should encourage patients to use
relaxation and music to enhance the effectiveness of pain
medication and hasten recovery." Dr. Good's findings have
implications for future research into the effectiveness of
self-care methods on other types of pain, including chronic pain,
cancer pain, and pain of the critically ill.
The NINR supports and conducts scientific research and research
training to reduce the burden of illness and disability; improve
health-related quality of life; and establish better approaches to
promote health and prevent disease. |
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