title: The effect of sunlight on postoperative analgesic medication use: a prospective study of patients undergoing spinal surgery.
abstract: OBJECTIVE
  Exposure to natural sunlight has been associated with improvement in mood, reduced mortality among patients with cancer, and reduced length of hospitalization for patients who have experienced myocardial infarction. Our aim was to evaluate whether the amount of sunlight in a hospital room modifies a patient's psychosocial health, the quantity of analgesic medication used, and the pain medication cost.
  
  
  METHODS
  A prospective study of pain medication use was conducted in 89 patients undergoing elective cervical and lumbar spinal surgery where they were housed on either the "bright" or "dim" side of the same hospital unit. Analgesic medication was converted to standard morphine equivalents for interpatient comparison. The intensity of sunlight in each hospital room was measured daily and psychologic questionnaires were administered on the day after surgery and at discharge.
  
  
  RESULTS
  Patients staying on the bright side of the hospital unit were exposed to 46% higher-intensity sunlight on average (p = .005). Patients exposed to an increased intensity of sunlight experienced less perceived stress (p = .035), marginally less pain (p = .058), took 22% less analgesic medication per hour (p = .047), and had 21% less pain medication costs (p = .047). Age quartile was the only other variable found to be a predictor of analgesic use, with a significant negative correlation (p <.001). However, patients housed on the bright side of the hospital consistently used less analgesic medications in all age quartiles.
  
  
  CONCLUSIONS
  The exposure postoperatively of patients who have undergone spinal surgery to increased amounts of natural sunlight during their hospital recovery period may result in decreased stress, pain, analgesic medication use, and pain medication costs.
authors.affiliation: Department of Pathology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. walchjm@upmc.edu
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Walch
authors.forename: Bruce S
authors.initials: BS
authors.lastname: Rabin
authors.forename: Richard
authors.initials: R
authors.lastname: Day
authors.forename: Jessica N
authors.initials: JN
authors.lastname: Williams
authors.forename: Krissy
authors.initials: K
authors.lastname: Choi
authors.forename: James D
authors.initials: JD
authors.lastname: Kang
mesh_terms: D000367:Age Factors; D000700:Analgesics / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D016527:Drug Costs; D004777:Environment; D005260:Female; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D010362:Patients' Rooms; D011446:Prospective Studies; D013123:Spinal Fusion / Q000523:psychology; D013131:Spine / Q000601:surgery*; D013472:Sunlight; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000700:Analgesics