title: Exploring the Impact of Intraoperative Interventions for Pain and Anxiety Management During Local Anesthetic Surgery-A Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  To compare the effectiveness of audiovisual and relaxation-based intraoperative interventions for their impact on intraoperative pain and anxiety.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  METHODS
  The following databases were searched for articles published between 1990 and January 2014: MEDLINE, PsychINFO, CINAHL, and Web of Science. Twenty randomized trials meeting the following inclusion criteria were included; adult participants undergoing elective outpatient surgery under local anesthetic using a form of distraction-based intraoperative intervention for the management of anxiety and pain.
  
  
  RESULTS
  Thirty percent of studies reviewed found that intraoperative interventions improved patient experience in comparison to treatment as usual, 20% of studies were inconclusive, and 50% of studies found that interventions during surgery provided no benefit.
  
  
  CONCLUSIONS
  Both relaxation-based and audiovisual interventions were found to be efficacious for pain and anxiety management during surgery under local anesthetic. This review indicates that relaxation-based interventions could be more effective than audiovisual interventions for managing intraoperative anxiety.
authors.forename: Briony F
authors.initials: BF
authors.lastname: Hudson
authors.forename: Jane
authors.initials: J
authors.lastname: Ogden
mesh_terms: D000772:Anesthesia, Local; D001007:Anxiety / Q000628:therapy*; D006801:Humans; D007432:Intraoperative Period; D059408:Pain Management / Q000379:methods*; D013514:Surgical Procedures, Operative
keywords: anxiety; interventions; pain; surgery