Kevin Gorsky 1 , Nick D Black 2 , Ayan Niazi 3 , Aparna Saripella 1 , Marina Englesakis 4 , Timothy Leroux 5 , Frances Chung 6 , Ahtsham U Niazi 7 Show Affiliations »
Abstract
BACKGROUND: Evidence suggests that over half of patients undergoing surgical procedures suffer from poorly controlled postoperative pain. In the context of an opioid epidemic, novel strategies for ameliorating postoperative pain and reducing opioid consumption are essential. Psychological interventions defined as strategies targeted towards reducing stress, anxiety, negative emotions and depression via education, therapy, behavioral modification and relaxation techniques are an emerging approach towards these endpoints. OBJECTIVE: This review explores the efficacy of psychological interventions for reducing postoperative pain and opioid use in the acute postoperative period. EVIDENCE REVIEW: An extensive literature search was conducted in MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Medline In-Process/ePubs, Embase, Ovid Emcare Nursing, and PsycINFO, Web of Science (Clarivate), PubMed-NOT-Medline (NLM), CINAHL and ERIC, and two trials registries, ClinicalTrials.Gov (NIH) and WHO ICTRP. Included studies were limited to those investigating adult human subjects, and those published in English. FINDINGS: Three distinct forms of psychological interventions were identified: relaxation, psychoeducation and behavioral modification therapy. Study results showed a reduction in both postoperative opioid use and pain scores (n=5), reduction in postoperative opioid use (n=3), reduction in postoperative pain (n=5), no significant reduction in pain or opioid use (n=7), increase in postoperative opioid use (n=1) and an increase in postoperative pain (n=1). CONCLUSION: Some preoperative psychological interventions can reduce pain scores and opioid consumption in the acute postoperative period; however, there is a clear need to strengthen the evidence for these interventions. The optimal technique, strategies, timing and interface requires further investigation. © American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.
BACKGROUND: Evidence suggests that over half of patients undergoing surgical procedures suffer from poorly controlled postoperative pain . In the context of an opioid epidemic, novel strategies for ameliorating postoperative pain and reducing opioid consumption are essential. Psychological interventions defined as strategies targeted towards reducing stress , anxiety , negative emotions and depression via education, therapy, behavioral modification and relaxation techniques are an emerging approach towards these endpoints. OBJECTIVE: This review explores the efficacy of psychological interventions for reducing postoperative pain and opioid use in the acute postoperative period. EVIDENCE REVIEW: An extensive literature search was conducted in MEDLINE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Medline In-Process/ePubs, Embase, Ovid Emcare Nursing, and PsycINFO, Web of Science (Clarivate), PubMed-NOT-Medline (NLM), CINAHL and ERIC, and two trials registries, ClinicalTrials.Gov (NIH) and WHO ICTRP. Included studies were limited to those investigating adult human subjects, and those published in English. FINDINGS: Three distinct forms of psychological interventions were identified: relaxation, psychoeducation and behavioral modification therapy. Study results showed a reduction in both postoperative opioid use and pain scores (n=5), reduction in postoperative opioid use (n=3), reduction in postoperative pain (n=5), no significant reduction in pain or opioid use (n=7), increase in postoperative opioid use (n=1) and an increase in postoperative pain (n=1). CONCLUSION: Some preoperative psychological interventions can reduce pain scores and opioid consumption in the acute postoperative period; however, there is a clear need to strengthen the evidence for these interventions. The optimal technique, strategies, timing and interface requires further investigation. © American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Entities: Disease
Species
Keywords:
acute pain; analgesics; opioid; pain; pain management; postoperative
Year: 2021
PMID： 34035150 DOI： 10.1136/rapm-2020-102434
Source DB: PubMed Journal: Reg Anesth Pain Med ISSN： 1098-7339 Impact factor: 6.288