Tim Brunson DCH

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The Use of Relaxation Techniques in the Perioperative Management of Proctological Patients



In a randomized, controlled clinical trial, researchers from Rome, Italy assessed the effects of guided imagery on the postoperative course in proctological patients. Patients undergoing surgery for anorectal diseases were randomized into group 1 (n = 43) with standard care and group 2 (n = 43) with relaxation techniques, where they listened to a guided imagery tape with music and relaxing text before, during, and after surgery.

Patients evaluated their own (a) postoperative pain measured by visual analogue score, (b) their quality of sleep measured by a similar score, and (c) the nature of first micturition (ed. note: fancy word for peeing, I believe), evaluated as normal or difficult. Groups were similar in age and sex distribution, type of disease, and operation performed. The pain score was 3.2 +/- 1.4 in GI patients and 4.1 +/- 2.1 in controls (P = 0.07). The quality of sleep score was 4.8 +/- 2.9 in GI patients and 6.4 +/- 2.7 in controls (P = 0.01). The first micturition was painful in 10.3% of GI patients and in 27.3% of controls (P = 0.09). Perioperative relaxation techniques thus showed a trend to reducing pain following anorectal surgery and significantly improving the quality of sleep; a decrease in anxiety and a consequent muscle relaxation may be involved. The study concludes that guided imagery is a low cost and noninvasive procedure, can be recommended as an helpful tool in this type of surgery.

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