Imagery Highly Effective for Children's Post Surgery Pain

Seventy-three children, aged 7-12, were recruited from five AS 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. They also listened to the audio tape 1-4 hours after surgery and 22-27 hours after discharge from AS. 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 37 children in the attention-control group received standard care. Pain and anxiety were measured at each time-point in both groups. Measures of sensory pain were the Oucher and amount of analgesics used in AS and home; affective pain was measured with the Facial Affective Scale (FAS). Anxiety was measured using the State Trait Anxiety Inventory for Children (STAIC).

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 non-opioid, did not differ between groups.

The study concludes that appropriately trained health care providers should use imagery to reduce post-operative pain following tonsillectomy and/or adenoidectomy in the ambulatory setting. In addition, it suggests thqat 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): pp. 439-48.