Relaxation and music to reduce postsurgical pain.
OBJECTIVE
We investigated the effects of relaxation, music, and the combination of relaxation and music on postoperative pain, across and between two days and two activities (ambulation and rest) and across ambulation each day. This secondary analysis of a randomized controlled trial was conducted from 1995 to 1997.


BACKGROUND
After surgery, patients do not always receive sufficient relief from opioids and may have undesired side-effects. More complete relief (10-30%) was found recently with adjuvant interventions of relaxation, music, and their combination. Comparison of effects between days and treatments have not been examined longitudinally.


METHODS
With a repeated measures design, abdominal surgery patients (n = 468) in five US hospitals were assigned randomly to one of four groups; relaxation, music, their combination, and control. With institutional approval and written informed consent, subjects were interviewed and taught interventions preoperatively. Postoperative testing was at ambulation and rest on days 1 and 2 using visual analogue (VAS) sensation and distress of pain scales.


RESULTS
Multivariate analysis indicated that although pain decreased by day 2, interventions were not different between days and activities. They were effective for pain across ambulation on each day, across ambulation and across rest over both days (all P < 0.001), and had similar effects by day and by activity.


CONCLUSIONS
Nurses can safely recommend any of these interventions for pain on both postoperative days and at both ambulation and rest.
Good
M
M
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA. mpg@po.cwru.edu
Stanton-Hicks
M
M
Grass
J A
JA
Anderson
G C
GC
Lai
H L
HL
Roykulcharoen
V
V
Adler
P A
PA
D003131:Combined Modality Therapy; D004434:Early Ambulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009147:Music Therapy / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000451:nursing / Q000517:prevention & control*; D012064:Relaxation Therapy; D012146:Rest; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome