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Nonpharmacologic interventions for pain and anxiety after hip and knee surgery.

25 Jul

Once again, researchers - this time at the University of Wisconsin - find that nonpharmacologic, mind-body techniques reduce pain and anxiety in orthopedic patients undergoing elective knee or hip replacement surgery

In a randomized, controlled, clinical trial, researchers from the University of Wisconsin studied orthopedic patients undergoing elective knee or hip arthroplasty, comparing degrees of pain and anxiety in those who received a kit of nonpharmacologic strategies in addition to their regularly prescribed analgesics, to those receiving pharacologic management alone.

Sixty-five patients were randomized to receive usual care or usual care plus the kit of nonpharmacologic strategies. Patients who received the kit tended to use less opioid medications and have less anxiety on postoperative day 1 (but this was not statistically significant) and used significantly less opioid drugs on postoperative day 2 than the patients who did not receive the kit, in spite of no differences in pain intensity.

There were no between-group differences in pain intensity. There were significant correlations among postoperative pain intensity, opioid use, and anxiety. The coping method of diverting attention was related to lower pain scores, and ignoring the pain was associated with higher pain.

The study concludes that providing a kit of nonpharmacologic strategies can increase the use of these methods for postoperative pain and anxiety and decrease the amount of opioid taken, and that the influence of coping strategies in acute postoperative pain needs to be examined further.

Citation: Pellino TA, Gordon DB, Engelke ZK, Busse KL, Collins MA, Silver CE, Norcross NJ. Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty. Orthopedic Nursing. 2005 May-Jun; 24 (3): pages 182-90; quiz 191-2.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award