Can a brief psychological expectancy intervention improve postoperative pain? A randomized, controlled trial in patients with breast cancer.
Acupuncture Therapy
Adolescent
Adult
Aged
Analgesia, Patient-Controlled
Analgesics, Opioid
/ therapeutic use
Breast Neoplasms
/ surgery
Double-Blind Method
Female
Humans
Middle Aged
Morphine
/ therapeutic use
Pain Management
Pain Measurement
Pain, Postoperative
/ drug therapy
Patient Satisfaction
Psychotherapy, Brief
/ methods
Socioeconomic Factors
Treatment Outcome
Young Adult
Journal
Pain
ISSN: 1872-6623
Titre abrégé: Pain
Pays: United States
ID NLM: 7508686
Informations de publication
Date de publication:
07 2019
07 2019
Historique:
pubmed:
7
3
2019
medline:
21
5
2020
entrez:
7
3
2019
Statut:
ppublish
Résumé
Pain after surgery remains a major health problem, calling for optimized treatment regimens to maximize the efficacy of pharmacological interventions. In this randomized controlled trial, we tested in a routine surgical treatment setting whether postoperative pain can be reduced by a brief preoperative intervention, ie, positive verbal suggestions in combination with sham acupuncture, designed to optimize treatment expectations. We hypothesized that the expectancy intervention as add-on to patient-controlled intravenous analgesia with morphine reduces patient-reported postoperative pain and improves satisfaction with analgesia. Ninety-six women undergoing breast cancer surgery were randomized at 2 stages: Before surgery, anesthesiologists delivered either positive or neutral verbal suggestions regarding the benefits of acupuncture needling on postoperative pain ("information condition"). Patients were then randomized to receive sham acupuncture or no sham acupuncture during postoperative care ("sham acupuncture condition"). Average pain during the 24-hour observation period after surgery as primary and satisfaction with analgesia as secondary outcome was assessed with standardized measures and analyzed with analysis of covariance accounting for morphine dose, surgery-related, and psychological parameters. Postoperative pain ratings were significantly reduced in patients who received positive treatment-related suggestions (F = 4.45, P = 0.038, main effect of information). Moreover, patients who received an intervention aimed at optimized treatment expectations reported significantly greater satisfaction with analgesia (F = 4.89, P = 0.030, interaction effect). Together, our proof-of-concept data support that optimizing treatment expectations through verbal suggestions may offer a promising approach to improve patient-reported outcomes. Future translational and clinical studies are needed to test such psychological strategies in different surgical interventions, patient groups, and pharmacological treatment regimens.
Identifiants
pubmed: 30839426
doi: 10.1097/j.pain.0000000000001546
pii: 00006396-201907000-00010
doi:
Substances chimiques
Analgesics, Opioid
0
Morphine
76I7G6D29C
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
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