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Medications and imaginations help reduce post-operative pain in children


A new study by a nurse researcher shows that imagery – a simple method of distraction – can be used with pain medications to significantly reduce post-operative pain in children.

In the study, which was led by a nurse researcher at Cincinnati Children’s Hospital Medical Center, children who had their tonsils or adenoids removed were given an audio tape that enabled them to imagine they were going to "a favorite place." The children who used the tape reported significantly lower pain in the 24 hours after surgery than those who didn’t use the tape.

"When treating pain in children, we should appeal not only to the senses but also to feelings and emotions," says Myra Huth, PhD, RN, assistant vice president of nursing research at Cincinnati Children’s and the study’s main author. "Pain medications should be used in conjunction with comfort techniques. However, we still have work to do in this area."

The NIH-funded study, published in the current issue (July) of the journal Pain, examined the effectiveness of imagery and pain medications in reducing pain and anxiety after surgery for tonsillectomy and at home. Dr. Huth recruited 73 children between the ages of 7 and 12. Approximately half watched a video tape on the use of imagery and listened to a 30 minute audio tape of imagery a week prior to surgery. One to four hours after surgery, they listened to the audio tape and then listened to the tape at home approximately 24 hours after surgery.

Those who used imagery reported significantly less pain after ambulatory surgery but not at home, perhaps because their anxiety had decreased by being at home. "Some children used the tape to help them sleep before their surgery," says Dr. Huth. "I think it helped relieve anxiety before surgery and on the day of surgery, but once they got back into a safe environment, it wasn’t as effective."

Dr. Huth examined pain only from the removal of tonsils or adenoids, but she believes imagery would be effective in reducing anxiety during children’s hospital stays and in distracting them during most intrusive procedures. Her study indicated that even when given less than the recommended amounts of pain medication, children who used imagery reported reduced pain. But she is a staunch proponent of both approaches.

"The need for interventions that reduce children’s acute pain on a short-term basis is growing as a result of the continued demand for outpatient surgery, shortened hospital stays and difficulties with pain management in both the ambulatory setting and at home," she says. "We need to get better in adequately dosing pain medications in conjunction with using distraction techniques," she says. "Nurses are beginning to think differently about how they practice and how they can help patients and families with non-traditional methods of pain management."

Jim Feuer | EurekAlert!
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