Music might be good not only for the ears,
but can also drive out excruciating post-operative pain.
Patients facing surgery can expect to have less post-op pain if they
mix relaxation and music with their pain medicine. A new study by a
nurse researcher has found that relaxation and music separately or
together, significantly reduce a patient's pain following major
abdominal surgery. Tested in addition to the usual pain medication,
these self-care methods reduced pain more than medication alone. The
research was reported in pain, the journal of the International
Association for the Study of Pains.
Marion Good, assistant professor of nursing at the Frances Payne
Bolton School of Nursing, studied 500 patients age 18 - 70 over a
29-month period in five Cleveland hospitals the Cleveland Clinic
Foundation, University Hospitals of Cleveland, Fairview General
Hospital, Mount Sinai Medical Center, and Southwest General health
center.
The research has important implications for millions who undergo
surgery and growl with postoperative pain. This pain can hamper
recovery by heightening the body's response to surgical stress and
increasing tissue breakdown, coagulation, and fluid retention. Pain
also interferes with appetite and sleeps and can lead to
complications that prolong hospitalization.
Reduction of pain may improve postoperative recovery. Music and
relaxation are useful for patients who have had incomplete relief
from pain medication, or who may wish to avoid side effects. They
may also be helpful to those who are anxious or who find these
methods appealing, relaxation and music are known to decrease
anxiety, reduce muscle tension, and district patients' attention
from pain. They are thought to affect the processes that modulate
the transmission of pain signals.
Non-pharmacological methods of controlling pain are not new.
Breathing, relaxation, and music have been used for many years to
ease the pain of childbirth, he said.
He and her research team tested relaxation, music, and their
combination during the first two days after surgery while patients
were resting and walking. They measured the patient's pain before
and after 15 minutes of bed rest and four times during ambulation to
see if the sensation and distress of pain changed.
One group used a jaw relaxation technique, another group listened to
music and third group received a combination of relaxation and
music. The control group received none of these. All study
participants received morphine or Demerol by pressing a button
connected to their intravenous patient controlled analgesia pumps.
In her study, Good randomly assigned patients with a computerized
program that also assured that the groups were similar regarding
gender, type of surgery, chronic pain, first surgery and
antidepressant use. The groups were also similar in demographic and
surgical factors, and in medication intake at time of treatment.
These were all things that could have confounded the outcome but did
not she said. Good and her research staff met with the patients
prior to surgery. The patients received music, relaxation, or a
combination of the two listened to an introductory tape, and
practiced using it during sitting and walking. The researchers
coached participants in the use of the assigned technique.
Patients using music selected one of five kinds of soothing music
harp, piano, synthesizer, orchestra, or slow jazz, then researchers
verified that study participants were able to use the music and
relaxation properly; after surgery, the relaxation, music and
combination groups used earphones to listen to tapes during
ambulation and rest, while the control group did not.
The study showed that the three treatment groups had significantly
less pain than the control groups at all measurement points during
ambulation and rest on the first and second days after surgery.
Traditionally, pain has not been adequately relieved following
surgery, patients often forget or are reluctant to press the button
on their PCA pump for fear of dependence or side effects, and the
results of this study promise reduced pain and possibly less need
for opined mediation.
Acute pain reminds us that we have had surgery and must allow
ourselves time to recuperate, Good said. Ambulation, although
painful, is important for recuperation, because it can prevent
complications. Unrelieved pain may contribute to complications,
however, therefore, pain can and should be controlled, not
prolonged. It is harder to reduce pain the longer it goes untreated.
Both medication and self care methods are needed for relief, he
said. This study showed that during both walking and rest, patients
who used relaxation, music, or the combination along with their
medication had less pain than those who used medication alone did.
Good recommends that physicians and nurses encourage patients to use
relaxation and music with medication to control post-operative pain.
Good and co-investigators were Michael Stanton-Hicks and Jeffery
Grass, physicians in the Department of Anesthesiology at the
Cleveland Clinic, and Gene Cranston Anderson the Edward J. and
Louise Mellen Professor at the Bolton School. The authors of the
article also include Charles Choi, a physician at Fairview General
Hospital, and two of Good's doctoral students, Laree School
Imeesters and Ali Salman.
Meanwhile, another research has shown that fearing the onset of pain
can sometimes be more traumatic than the real thing. This is because
the brain puts as much effort into anticipating potentially painful
events as it does to creating the pain experience itself.
Scientists in Oxford and Canada have found areas in the brain which
deal specifically with the expectation of pain, when those areas are
stimulated they trigger fear or anxiety, causing mood swings or even
behavioral changes.
Magnetic resonance imaging was used to monitor brain activity in
volunteers as they felt a series of painlessly warm and painfully
hot sensations in their left hands. Each sensation was signaled
advance by a colored light.
The results showed that expecting pain caused activity in parts of
the brain separate from, but close to sites, which dealt with the
pain experience itself.
The fact that our brains are wired this way could make good
evolutionary sense, as it encourages us to avoid painful vents.
Previous studies spotted the changes in brain activity, but assumed
they were caused by the pain, the new research proves for the first
time that it is instead linked to the anticipation of pain.
A better understanding of how the brain prepares the body for
painful experiences could one-day lead.
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