Tim Brunson DCH

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Imagery and Tonsillectomy in Children

Investigators at Cincinnati Children's Hospital Medical Center conducted a randomized, controlled, clinical trial investigating the effectiveness of imagery, in addition to routine analgesics, in reducing tonsillectomy and/or adenoidectomy pain and anxiety after ambulatory surgery (AS) and at home.

Seventy-three children, aged 7-12, were recruited from five ambulatory surgery settings. Thirty-six children randomly assigned to the treatment group watched a professionally developed videotape on the use of imagery and then listened to a 30-minute audio tape of imagery approximately 1 week prior to surgery (T1). They listened to the audio tape 1-4 hours after surgery (T2), and 22-27 hours after discharge from AS (T3). The 37 children in the attention-control group received standard care. Pain and anxiety were measured at each time-point in both groups.

When controlling for trait anxiety and opioid and non-opioid intake 1-4 hours before the pain measures, MANCOVA showed significantly lower pain and anxiety in the treatment group at T2, but not at T3. The study concludes that appropriately trained health care providers should use imagery to reduce post-operative pain following tonsillectomy and/or adenoidectomy in ambulatory surgery. In addition, teaching parents about adequate home administration of analgesics may increase the effectiveness of imagery at home.

Citation: Huth MM, Broome ME, Good M. Imagery reduces children's post-operative pain. Pain. 2004 Jul;110(1-2):439-48. myra.huth@cchmc.org

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