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This one is about: Guided Imagery and Surgery

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Guided imagery uses the power of thought to influence psychologic and physiologic states. Some studies have shown that guided imagery can decrease anxiety, analgesic requirements, and length of stay for surgical patients. This study was designed to determine whether guided imagery in the preoperative period could improve the outcome of colorectal surgery patients.

The authors conducted a randomized trial of patients undergoing their first elective colorectal surgery. Patients were randomly assigned into one of two groups. Group 1 received standard perioperative care, and Group 2 listened to a guided imagery tape three days preoperatively; a music-only tape during induction, during surgery, and post operatively in the recovery room; a guided imagery tape during each of the first six postoperative days. Both groups had postoperative patient-controlled analgesia.

All patients rated their levels of pain and anxiety daily, on a linear scale of 0 to 100. Total narcotic consumption, time to first bowel movement, length of stay, and number of patients with complications were also recorded. Both groups were similar in age and gender distribution, diagnoses, and surgery performed. The median baseline anxiety score was 75 in both groups.

Before surgery, anxiety increased in the control group but decreased in the guided imagery group. Post operatively, median increase in the worst pain score was 72.5 for the control group and 42.5 for the imagery group. Least pain was also significantly different, with a median increase of 30 for controls and 12.5 for the  imagery group.

Total narcotic requirements were significantly lower in the imagery group, with a median of 185 mg vs. 326 mg in the control group. Time to first bowel movement was significantly less in the imagery group (median, 58 hours) than in the control group (median, 92 hours). The number of patients experiencing postoperative complications (nausea,
vomiting, pruritus, or ileus) did not differ in the two groups.

The authors conclude that guided imagery significantly reduces postoperative anxiety, pain, and narcotic requirements of colorectal surgery and increases patient satisfaction. Guided imagery is a simple and low-cost adjunct in the care of patients undergoing elective colorectal surgery.

Guided imagery: a significant advance in the care of patients undergoing elective colorectal surgery.Tusek DL, Church JM, Strong SA, Grass JA, Fazio VW

Dis Colon Rectum 1997 Feb;40(2):172-178

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