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.