Guided Imagery Can Reduce Children's Postoperative Pain

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Guided Imagery Can Reduce Children's Postoperative Pain

NEW YORK (Reuters Health) Aug 12 - Guided imagery along with medication

can be used to reduce postoperative pain and anxiety in children, new

study findings suggest.

" 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, " Dr. Myra Martz

Huth and colleagues point out in their report, published in the July

issue of Pain.

Their study was designed to test the efficacy of a professionally

developed program, " To Tame the Hurting Thing, " comprised of booklets,

videotapes and audiotapes.

Dr. Huth, at Cincinnati Children's Hospital Medical Center in Ohio, and

colleagues recruited 73 children ages 7 to 12 years scheduled to undergo

tonsillectomy or adenoidectomy or both. The children were randomized to

the experimental intervention or to a control group that received

standard care.

The videotape, given to patients during the 3 weeks prior to surgery,

taught deep breathing and imagery techniques, while the audiotape

included deep breathing and muscle relaxation exercises, music, and

suggestions for picturing a favorite place.

The patients practiced with the audiotape between two and eight times

prior to surgery, and repeated it 1 to 4 hours after surgery and in the

home 22 to 24 hours after discharge.

Sensory pain was measured with the Oucher scale, a 0-100-point numeric

scale, and anxiety was assessed with the State Anxiety Inventory for

Children. Affective pain was measured with the Facial Affective Scale,

which consists of nine cartoon-like faces denoting positive, negative

and neutral emotional expression.

Children in the intervention group reported significantly less pain and

anxiety after listening to the audiotape immediately after surgery:

28.3% less sensory pain, 10.5% less anxiety and 8.5% less affective

pain. Although the difference was no longer statistically significant

when measured in the home, the intervention group still exhibited 18.6%

less sensory pain, 9.2% less anxiety and 8.2% less affective pain.

The use of analgesics, both opioid and nonopioid did not differ between

groups.

" We need to get better in adequately dosing pain medications in

conjunction with using distraction techniques, " Dr. Huth comments in a

Cincinnati Children's Hospital press statement. " Nurses are beginning to

think differently about how they practice and how they can help patients

and families with nontraditional methods of pain management. "

Pain 2004;110:439-448.