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Case Western Reserve University finds relaxation therapy reduces post-operative pain


A study conducted by researchers at Case Western Reserve University found that patients who used a relaxation technique, called "systematic relaxation," experienced a substantial decrease in pain after undergoing surgery. The systemic relaxation technique, which consists of sequentially relaxing each major muscle group in the body, was shown to improve comfort by more than 50 percent compared to patients not using the technique. Patients in the study could also request pain medication.

The study was conducted at a large hospital in Thailand in 2002 and was published in the September 2004 issue of the Journal of Advanced Nursing.

The randomized clinical trial occurred during the 15 minutes after patients took their first walk after surgery. Since walking increases post-operative pain, the investigators wanted to see if after returning to bed and resting for 15 minutes, the pain was less in those who used relaxation compared to those who did not.

"What we concluded from the research is that systematic relaxation can have a significant effect on reducing pain from severe to mild levels in patients who undergo complicated surgeries," said Marion Good, Ph.D., RN, F.A.A.N at the Frances Payne Bolton School of Nursing at Case. "In addition, the far-reaching effects are that this kind of patient self-care may ultimately help to reduce the need for nursing care, which is important given the current costs associated with nursing care and a shortage of nurses in many countries."

Patients in the "relaxation" group used a tape recorder and listened to an audio tape which asked them to lie in a comfortable position in bed, close their eyes, and relax each major body part, in succession, starting with the feet, lower legs and hips moving up the body toward the head. Each suggestion was given in a soft voice and was repeated a second time. The five-minute relaxation technique was then repeated three times during the 15-minute tape. At the end of the session, the participants who used relaxation were asked to open their eyes and lie quietly for a few minutes.

"The patients who underwent this complementary therapy for pain reported feeling less sensation and pain during 15 minutes following the first walk after gynecological, intestinal and exploratory abdominal surgeries," said Varyunyupa Roykulcharoen, Ph.D, R.N, researcher and recent graduate of the France Payne Bolton School of Nursing’s doctoral program at Case. Dr. Roykulcharoen is currently an assistant professor at Red Cross College of Nursing in Bangkok, Thailand.

The study aimed to examine the effects of systematic relaxation on the sensory and affective components of postoperative pain, anxiety, and requests for pain medication. The study used a random sample of 102 adults who underwent various abdominal surgeries. After the adults were randomly assigned to the two groups, systematic relaxation was used for the first 15 minutes after surgery. The patient’s pain was then measured with Visual Analogue Sensation and Distress of Pain Scales, which are 100-millimeter horizontal lines on which the patient marked the amount of hurt in the abdomen, from none to most sensation and the amount of emotional upset, from none to most distress. Researchers believe those who used relaxation learned to use self-care and be actively involved in their pain management, which is critical for optimal relief.

The "relaxation" group reported a large effect on pain; they had 55 percent less post-test sensation and pain than those in the "control" group, who just rested in bed. Relaxation did not result in significantly less anxiety; but group differences in anxiety were in the direction of what researchers expected. It was also noted that fewer participants in the "relaxation" group requested pain medicine in the next six hours, and nearly all reported at the end of the study that systematic relaxation reduced their pain and increased their sense of control.

Laura Massie | EurekAlert!
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